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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 10/26/2020 <br /> WCR2020-015110 <br /> Owner's Well Number Date Work Began 10/13/2020 Date Work Ended 10/13/2020 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number WP0041303 Permit Date 10/06/2020 <br /> Well Owner(must remain confidential pursuant to Water Code 13752) Former Use <br /> Name CYNTHIA SMITH Activity Destroy <br /> Mailing Address 17710 E CEDAR LN Former Use Water Supply <br /> City RIPON State CA Zip 95366 <br /> Well Location <br /> Address 17710 E CEDAR LN APN 245-140-060 <br /> City RIPON Zip 95366 County San Joaquin Township <br /> Latitude 37 46 53.0795 N Longitude -121 5 30.4008 W Range <br /> Section <br /> Deg. Min. Sec. Deg. Min. Sec. <br /> Baseline Meridian <br /> Dec. Lat. 37.781411 Dec.Long. -121.091778 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 Drilling Fluid Depth to Static <br /> Water Level 0 (Feet) Date Measured 10/13/2020 <br /> Total Depth of Boring Feet Estimated Yield' (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 60 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> 6\"PVC WELL FILLED WITH BENTONITE AND CAPPED OFF WITH A 3FT MUSHROOM CAP <br /> Other Observations: <br /> INSPECTED BY SAN JOAQUIN COUNTY 10.13.2020 <br /> OCT 2 8 2020 <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />