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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 9/14/2022 <br />WCR2022-010673 <br />Owner's Well Number Date Work Began 08/19/2022 Date Work Ended 08/19/2022 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number wp0043517 Permit Date 07/20/2022 <br />Well Owner (must remain confidential pursuant to Water Code 13752) Former Use <br />Name DARRYL VAN GRONINGEN Activity Destroy <br />Mailing Address 9936 LYONS RD Former Use Water Supply <br />City RIPON State CA Zip 95366 I I <br />Well Location <br />Address 9936 LYONS RD APN 257-240-440 <br />City RIPON Zip 95366 County San Joaquin Township 02S <br />Latitude 37 43 54.4764 N Longitude -121 11 8.6136 W Range 07 E <br />Section 27 <br />Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br />Dec. Lat. 37.731799 Dec. Long. -121.185726 Ground Surface Elevation 53 <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 08/19/2022 <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 />6"X 50' WELL DESTRUCTION <br />Other Observations: <br />COUNTY INSPECTOR <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />