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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 1119/2021 <br /> WCR2021-014298 <br /> Owner's Well Number Date Work Began 11/05/2021 Date Work Ended 11/05/2021 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 42724 Permit Date 11/04/2021 <br /> Well Owneelmilulitr*eim'a"i'lint"46 4ifidi 1 0li M6WOi -I <br /> Former <br /> A!�! <br /> Name YOSEMITE-MCKINLEY THREE LLC, Activity Destroy <br /> Mailing Address 4460 S.Hwy 99 Frontage Rd. Former Use Water Supply <br /> City Stockton State CA Zip 95215 <br /> Vall Location <br /> Address 3356 W Yosemite AVE APN 241-400-36 <br /> City Lathrop Zip 95330 County San Joaquin Township 02S <br /> Latitude 37 47 42.1058 N Longitude -121 —16 35.7488 W Range 06 E <br /> Section 02 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.7950294 Dec.Long. -121.2765969 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Elevation Determination Method <br /> Method <br /> Borehole Information ,3 h <br /> '0.a-Y1610� FCOMPIOW <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 180 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> Pumped bentonite from bottom to the top of an 8in PVC well,depth 180 ft.Dug down,cut off casing,mushroom top with bentonite,cement cap on top.Buried <br /> with native soil. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page_1 of 2 <br />