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State of Califomia <br /> Well Completion Report <br /> Form DWR 188 Submitted 5/6/2021 <br /> WCR2021-005565 <br /> Owner's Well Number Date Work Began 04/13/2021 Date Work Ended 04121/2021 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 41921 Permit Date 04114/2021 <br /> 110- <br /> W W� <br /> seian <br /> ;-., <br /> M "A Vty, <br /> C"d <br /> -,"Or !pWre a� c pursuant, <br /> Name Ken Lane Activity Drill and Destroy <br /> Mailing Address 30003 S.Koster Rd. Planned Use Destruction <br /> City Tracy State CA Zip 95304 <br /> W <br /> Address 30003 S Koster RD APN 255-320-03 <br /> City Tracy Zip 95304 County San Joaquin Township 03S <br /> Latitude 37 40 53.959 N Longitude -121 19 31.5951 W Range 06 E <br /> Section 17 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.6816553 Dec.Long. -121.3254431 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Method Elevation Determination Method <br /> :116 M0 ...... <br /> rn! <br /> Borehole`M& nd-Y,"J'4d' <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Other-Mud Rotary Drilling Fluid Water Depth to Static <br /> Rig Water Level (Feet) Date Measured <br /> Estimated Yield* (GPM) Test Type <br /> Total Depth of Boring 260 Feet Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well Feet *May not be representative of a well's long term yield. <br /> Geolo CF,La'gl--, Frqe.i <br /> Depth from <br /> Surface Description <br /> Feet to Feet <br /> 0 75 clay <br /> 75 78 sand <br /> 78 125 clay <br /> 125 131 sand <br /> 131 137 shale <br /> 137 138 sand <br /> 138 232 clay <br /> 232 260 blue clay <br /> Form DWR 188 rev. 12/19/2017 Page—1 of—2 <br />