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RC CEIVED <br /> State of California OCT 19 2020 <br /> Well Completion Report <br /> Form DWR 188 Submitted 10/15/2020 I„NV II���IV1N1Li�TAL HEALTHWC R2020-014703 DEPARTMENT <br /> Owner's Well Number Date Work Began 10/02/2020 Date Work Ended 10/05/2020 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number WP0041231 Permit Date 09/16/2020 <br /> Well Owner(must remain confidential pursuant to Water Code 13752) Planned Use and Activity <br /> Name ALISSA BEREZAY Activity New Well <br /> Mailing Address 912 MISSION RIDGE DR Planned Use Water Supply Domestic <br /> City MANTECA State CA Zip 95337 <br /> Well Location <br /> Address 18915 CARROLTON RD APN 245-380-310 <br /> City RIPON Zip 95366 County San Joaquin Township <br /> Latitude 37 47 21.2532 N Longitude -121 4 15.6359 fin/ Range <br /> Section <br /> Deg. Min. Sec. Deg. Min. Sec. <br /> Baseline Meridian <br /> Dec.Lat. 37.789237 Dec.Long. -121.07101 Ground Surface Elevation 83 <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br /> Location Accuracy Unknown Location Determination Method Other Elevation Determination Method Digital Aerial Photo <br /> Borehole Information Water Level and Yield of Completed Well <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Direct Rotary Drilling Fluid Bentonite Depth to Static <br /> Water Level 70 (Feet) Date Measured 10/05/2020 <br /> Total Depth of Boring 310 Feet Estimated Yield* (GPM) Test Type Air Lift <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 280 Feet May not be representative of a well's long term yield. <br /> Geologic Log - Free Form <br /> Depth from <br /> Surface Description <br /> Feet to Feet <br /> 0 2 TOP SOIL <br /> 2 8 SAND <br /> 8 10 CLAY <br /> 10 16 SAND <br /> 16 22 CLAY <br /> 22 28 SAND <br /> 28 98 CLAY <br /> 98 112 SAND <br /> 112 128 CLAY <br /> 128 138 SAND <br /> 138 228 CLAY <br /> 228 236 SAND <br /> 236 260 CLAY <br /> 260 265 SAND <br /> 265 274 CLAY <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />