Laserfiche WebLink
State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 2/1/2022 <br /> WCR2022-001571 <br /> Owner's Well Number Date Work Began 01/28/2022 Date Work Ended 01/28/2022 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 42570 Permit Date 09/20/2021 <br /> E <br /> Well Owner(�riust`re�iiaV ffconfidential pu�suan fo Wate`r„Code'13752j er}Use k,�i ; <br /> _. .. rm <br /> Fo <br /> Name Thomas Seibly Activity Destroy <br /> Mailing Address P.O.Bos 245 Former Use Water Supply <br /> City Acampo State CA Zip 95220 <br /> ., , Well Location,` , <br /> Address 201 E Jahant RD APN 003-100-15 <br /> City Acampo Zip 95220 County San Joaquin Township 04 N <br /> Latitude 38 12 29.0631 N Longitude -121 18 53.9719 W Range 06 E <br /> Section 10 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 38.2080731 Dec.Long. -121.3149922 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Elevation Determination Method <br /> Method <br /> r"Borehole lnforllnation Water-Levelfand Yleld of Completed Welt.,: <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 28 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> Freefall cement into an 8in steel casing well,mushroom the top. <br /> Dug down with excavator 5ft,cut off casing,buried with native soil. <br /> Other Observations: <br /> Form DWR 188 rev. 12/1912017 Page 1 of 2 <br />