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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 1/26/2021 <br />WCR2021-000958 <br />Owner's Well Number Date Work Began 12/21/2020 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0041527 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name KASMER BARACOSA <br />Mailing Address 5888 E VERIGAN RD <br />City MANTECA <br />State CA Zip 95336 <br />Well Location <br />Date Work Ended 12/23/2020 <br />Permit Date 12/14/2020 <br />Planned Use and Activity <br />Activity New Well <br />Planned Use Water Suooly Domestic <br />Address 5888 E VERIGAN RD APN 197-120-430 <br />City MANTECA Zip 95336 County San Joaquin Township <br />Latitude 37 50 19.8672 N Longitude -121 12 38.2067 W Range <br />Section <br />Deg. Min. Sec. Deg. Min. Sec. <br />Baseline Meridian <br />Dec. Lat. 37.838852 Dec. Long. -121.210613 Ground Surface Elevation 55 <br />Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br />Location Accuracy Unknown Location Determination Method Elevation Determination Method Digital Aerial Photo <br />Borehole Information <br />Orientation Vertical <br />Drilling Method Direct Rotary Drilling Fluid <br />Specify <br />Bentonite <br />Water Level and Yield of Completed Well <br />Depth to first water (Feet below surface) <br />Depth to Static <br />Water Level 44 (Feet) Date Measured 12/23/2020 <br />Estimated Yield' (GPM) Test Type Air Lift <br />Test Length (Hours) Total Drawdown (feet) <br />'May not be representative of a well's long term yield. <br />Total Depth of Boring 270 Feet <br />Total Depth of Completed Well 260 Feet <br />Geologic Log - Free Form <br />Depth from <br />Surface <br />Feet to Feet <br />Description <br />0 13 <br />SAND <br />13 16 <br />CLAY <br />16 28 <br />SAND <br />28 33 <br />CLAY <br />33 38 <br />SAND AND GRAVEL <br />38 53 <br />CLAY <br />53 59 <br />SAND <br />59 105 <br />CLAY <br />105 147 <br />SAND <br />147 157 <br />CLAY <br />157 163 <br />SAND <br />163 246 <br />CLAY <br />246 253 <br />SAND <br />253 270 <br />CLAY <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />