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' State of California Well Completion Report Form DWR 188 Submitted 7/20/2021 WCR2021-009043 Owner's Well Number Date Work Began 12/30/2020 Local Permit Agency San Joaquin County Environmental Health Department Secondary Permit Agency Permit Number WP0041456 Well Owner (must remain confidential pursuant to Water Code 13752) Name DANJOHNSON Mailing Address 29855 ORANGE AVE City ESCALON State CA Zip 95320 Well Location Date Work Ended 12/30/2020 Permit Date 11/19/2020 Planned Use and Activity Activity New Well Planned Use Water SUDDIV Domestic Address 29855 ORANGE AVE APN 249-180-090 City ESCALON Zip 95320 County San Joaquin Township 02S Latitude 37 46 25.7555 N Longitude -120 56 36.3804 W Range 09 E Section 11 Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo Dec. Lat. 37.773821 Dec. Long. -120.943439 Ground Surface Elevation 148 Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Location Accuracy Unknown Location Determination Method GPS Elevation Determination Method Borehole Information Depth from Surface Feet to Feet Water Level and Yield of Completed Well Orientation Vertical Specify Depth to first water (Feet below surface) CLAY 16 23 Depth to Static Drilling Method Direct Rotary Drilling Fluid Bentonite 45 71 SAND 71 86 Water Level 86 (Feet) Date Measured 12/30/2020 Estimated Yield' (GPM) Test Type Air Lift 86 102 Total Depth of Boring 285 Feet Test Length (Hours) Total Drawdown (feet) Total Depth of Completed Well 270 Feet •May not be representative of a well's long term yield. Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 5 TOP SOIL 5 16 CLAY 16 23 SAND 23 45 CLAY 45 71 SAND 71 86 CLAY 86 102 GRAVEL 102 105 CLAY 105 126 SAND 126 160 CLAY 160 176 SAND & GRAVEL 176 234 CLAY 234 238 SAND 238 249 CLAY 249 255 SAND Form DWR 188 rev. 12/19/2017 Page 1 of 2