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State of Califomia <br /> Well Completion Report <br /> Form DWR 188 Submitted 4113/2021 <br /> WCR2021-004488 <br /> Owner's Well Number Date Work Began 03/04/2021 Date Work Ended 03/16/2021 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 41771 Permit Date 03/08/2021 <br /> Well:4wner� must;reima�n;coilfidential'�iiarsuantto�Water=Code=13752 F rmer Use <br /> t.. p <br /> �. 1 Q.t ;- <br /> Name VINTAGE 11 L.P., Activity Destroy <br /> Mailing Address 135 Fifth St. Former Use Water Supply <br /> City Oakdale State CA Zip 95361 <br /> Address 1272 E Woodward AVE APN 224-050-08 <br /> City Manteca Zip 95337 County San Joaquin Township <br /> Latitude 37 46 31.2596 N Longitude -121 16 59.6636 W Range <br /> Section <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian <br /> Dec.Lat. 37.7753499 Dec.Long. -121.2832399 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Method Elevation Determination Method <br /> .: ...., ... ,..,. .,,P...• �,.,,..,;; I".. ....:.... ..,.., s..;.,- ,.t, .s..:•-t rl_'.:yt Wed c t' <br /> .. ..s_, «.,.., ... ,... .. ,,..1,.a �..:. a,: e., ..:' ', .sssxt_ - a ._ sz., <br /> t .:. Y 4.;i; :(ia,#F3.4'2 >`r *a t €' <br /> .:Borehola Information ,., ,< :'} Vllater Diel-and.Yjel vt <br /> ,{' 4 +. � f' f� <br /> w3..tt,`,�. �-.Sc,.xEa,6".,�.- �.�..1{u{:+..1��� �1..-.... <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Drilling Fluid Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring Feet Estimated Yield* (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 100 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> Pulled pump out of a 61n steel cased well.Pumped 10.3 sack mix cement from bottom to the top,mushroom cap.Dug down,cut off casing 5ft below ground <br /> level,buried with native material. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />