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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 8/17/2022 <br />W C R2022-009650 <br />Owner's Well Number Date Work Began 05/05/2022 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0043161 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name DYLAN GOODWIN <br />Mailing Address 1318 N. AIRPORT WAY <br />City MANTECA <br />State CA Zip 95336 <br />Well Location <br />Date Work Ended 05/09/2022 <br />Permit Date 04/11/2022 <br />Former Use <br />Activity Destroy <br />Former Use Water Supply <br />Address 10416 E SOUTHLAND RD APN 208-070-280 <br />City MANTECA Zip 95336 County San Joaquin Township 01 S <br />Latitude 37 49 5.5416 N Longitude -121 10 38.2475 W Range 07 E <br />Section 26 <br />Deg. Min. Sec. Deg. Min. Sec. <br />Baseline Meridian Mount Diablo <br />Dec. Lat. 37.818206 Dec. Long. -121.177291 Ground Surface Elevation 49 <br />Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br />Location Accuracy >50 Ft Location Determination GPS Elevation Determination Method Digital Aerial Photo <br />Method <br />Borehole Information <br />Water Level and Yield of Completed Well <br />Orientation Vertical Specify <br />Depth to first water (Feet below surface) <br />Depth to Static <br />Drilling Method Drilling Fluid <br />Water Level 0 (Feet) Date Measured 05/05/2022 <br />Estimated Yield* (GPM) Test Type <br />Total Depth of Boring Feet <br />Test Length (Hours) Total Drawdown (feet) � <br />Total Depth of Completed Well 0 Feet <br />*May not be representative of a well's long term yield. <br />Destruction Details: <br />50'X 6" WELL DESTRUCTION <br />Other Observations: <br />COUNTY INSPECTOR AARON <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />