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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 1217/2021 <br /> WCR2021-015523 <br /> Owner's Well Number Date Work Began 12/02/2021 Date Work Ended 12103/2021 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 42772 Permit Date 12/01/2021 <br /> Former so-: <br /> re <br /> malacon il entl# <br /> Well Owner(Mditi fid I J­­ Water' ) <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 11 <br /> ca <br /> -i.5", Me I I Lo R16K <br /> i M <br /> Address 1357 Veteran ST APN 224-710-62 <br /> City Manteca Zip 95337 County San Joaquin Township 02S <br /> Latitude 37 46 31.6459 N Longitude -121 —11 28.7847 W Range 07 E <br /> Section 10 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.7754572 Dec.Long. -121.1913291 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Elevation Determination Method <br /> Method <br /> i6d Will <br /> r,� <br /> YjOj <br /> e <br /> orma on'. a I <br /> e <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Drilling Fluid Depth to Stafic <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 94 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> Pumped bentonite from the bottom to the top of an Bin PVC well which was 94ft deep.Dug down 5ft,cut off casing,put a cement cap on top and buried with <br /> native soil. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />