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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 8/15/2022 <br />WCR2022-009520 <br />Owner's Well Number Date Work Began 07/11/2022 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0043037 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name HOPE DAVIS <br />Mailing Address 1813 MONTEREY PINE AVE. <br />City CERES <br />State CA Zip 95307 <br />Well Location <br />Date Work Ended 07/15/2022 <br />Permit Date 03/03/2022 <br />Former Use <br />Activity Destroy <br />Former Use Water Supply <br />Address 9957 ESCALON BELLOTA RD APN 207-030-090 <br />City ESCALON Zip 95320 County San Joaquin Township 01S <br />Latitude 37 52 36.5771 N Longitude -120 59 59.9639 W Range 09 E <br />Section 05 <br />Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br />Dec. Lat. 37.876827 Dec. Long. -120.99999 Ground Surface Elevation 108 <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 07/15/2022 <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 />165'X 8" WELL DESTRUCTION <br />Other Observations: <br />COUNTY INSPECTOR AARON <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />