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I State of California Well Completion Report Form DWR 188 Submitted 8/2/2022 WCR2022-008989 Owner's Well Number Date Work Began 05/12/2022 Local Permit Agency San Joaquin County Environmental Health Department Secondary Permit Agency Permit Number WP0043113 Well Owner (must remain confidential pursuant to Water Code 13752) Name GERRIT HOFFMAN Mailing Address 4820 PERRIN RD City MANTECA State CA Zip 95337 II Well Location Date Work Ended 05/13/2022 Permit Date 03/23/2022 Planned Use and Activity Activity New Well Planned Use Water Supply Domestic Address 4820 PERRIN RD APN 257-030-210 City MANTECA Zip 95337 County San Joaquin Township 02S Latitude 37 43 27.4943 N Longitude -121 14 52.1591 W Range 07 E Section 31 Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo Dec. Lat. 37.724304 Dec. Long. -121.247822 Ground Surface Elevation 28 Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown Location Accuracy >50 Ft Location Determination GPS Elevation Determination Method Digital Aerial Photo Method Borehole Information Orientation Vertical Drilling Method Direct Rotary Drilling Fluid Specify Bentonite Water Level and Yield of Completed Well Depth to first water (Feet below surface) Depth to Static Water Level 14 (Feet) Date Measured 05/13/2022 Estimated Yield' (GPM) Test Type Air Lift Test Length (Hours) Total Drawdown (feet) `May not be representative of a well's long term yield. Total Depth of Boring 280 Feet Total Depth of Completed Well 218 Feet Geologic Log - Free Form Depth from Surface Feet to Feet Description 0 4 TOP SOIL 4 6 CLAY 6 58 SAND 58 68 BLUE CLAY 68 78 BROWN CLAY 78 83 BROWN SAND 83 103 BROWN CLAY 103 108 BROWN SAND 108 128 BROWN CLAY 128 146 BLUE CLAY 146 153 BLUE SAND 153 158 BROWN CLAY 158 165 BROWN SAND 165 168 BLUE CLAY Form DWR 188 rev. 12/19/2017 Page 1 of 2