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r � <br />State of California <br />Well Completion Report <br />Form DWR 188 Submitted 8/8/2022 <br />WCR2022-009172 <br />Owner's Well Number Date Work Began 08/27/2021 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0042350 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name TOM PEREIRA <br />Mailing Address 15355 W GRANT LINE RD. <br />City TRACY <br />State CA Zip 95304 <br />Well Location <br />Date Work Ended 08/30/2021 <br />Permit Date 07/28/2021 <br />Planned Use and Activity <br />Activity New Well <br />Planned Use Water Supply Domestic <br />Address 15355 W GRANT LINE RD APN 209-190-310 <br />City TRACY Zip 95304 County San Joaquin Township 02S <br />Latitude 37 45 31.1328 N Longitude -121 29 57.9948 W Range 04 E <br />Section 14 <br />Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br />Dec. Lat. 37.758648 Dec. Long. -121.499443 Ground Surface Elevation 43 <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 />Depth from <br />Surface <br />Feet to Feet <br />Water Level and Yield of Completed Well <br />Orientation Vertical <br />Specify <br />Depth to first water (Feet below surface) <br />CLAY <br />37 48 <br />Depth to Static <br />Drilling Method Direct Rotary Drilling Fluid <br />Bentonite <br />Water Level 92 (Feet) Date Measured 08/30/2021 <br />BLUE CLAY <br />264 268 <br />Estimated Yield' (GPM) Test Type Air Lift <br />268 325 <br />Total Depth of Boring 325 <br />Feet <br />Test Length (Hours) Total Drawdown (feet) <br />Total Depth of Completed Well 278 <br />Feet <br />'May not be representative of a well's long term yield. <br />Geologic Log - Free Form <br />Depth from <br />Surface <br />Feet to Feet <br />Description <br />0 3 <br />TOP SOIL <br />3 37 <br />CLAY <br />37 48 <br />SAND <br />48 151 <br />CLAY <br />151 264 <br />BLUE CLAY <br />264 268 <br />BLUE SAND <br />268 325 <br />BLUE CLAY <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />