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State of Califomia <br /> Well Completion Report <br /> Form DWR 188 Submitted 712012021 <br /> WCR2021-009054 <br /> Owner's Well Number Date Work Began 0211612021 Date Work Ended 02117/2021 <br /> Local Permit Agency San Joaquin County Environmental Heatth Department <br /> Secondary Permit Agency Permit Number WP0041468 Permit Date 11/2312020 <br /> Well owner(must remain cofffidential pursuant to Water Code 13752) Planned Use and Activity <br /> Name DAVE VAN VLIET <br /> Activity New Well <br /> Mailing Address 17324 LONE TREE RD <br /> Planned Use Water Supply Irrigation - <br /> Agriculture <br /> City ESCALON State CA Zip 95320 <br /> I <br /> Well Location <br /> Address 17050 LONE TREE RD APN 203-21M50 <br /> City ESCALON Zip 95320 County San Joaquin Township 016 <br /> Latitude 37 49 37.092 N Longitude -121 5 56.401 W Range 08 E <br /> Section 28 <br /> Deg, Min, Sec, Deg- Min. Sec, Baseline Meridian Mount Diahio <br /> Dec. Lai. 37-82697 Dec. Long. -121.099"3 Ground Surface Elevation fig <br /> Verticat Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br /> Location Accuracy Unknown Location Determination Method GPS Elevation Determination Method Digital Aerial Photo <br /> Borehrl'ie information 'Water Level and Yield of Completed Wei# <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Direct Rotary Qnlling Fluid Bentonite Depth to Static <br /> I Water Level 78 (Feet) Date Measured 0211712021 <br /> Total Depth of Boring 415Feet Estimated Yield' (GPM) Test Type Air Lift <br /> Test Length (Flours) Total Drawdown [feet] <br /> Total Depth of Completed Weil 3$5 Feet -May not be representative of a well's long term yield. <br /> Geologic Log-Free Form <br /> Depth from <br /> Surface Description <br /> Feet to Feet <br /> 0 3 TOP SOIL <br /> 3 6 HARD PAID <br /> 6 13 SAND <br /> 13 43 CLAY <br /> 43 50 SAND <br /> 5D 78 CLAY <br /> 78 85 SAND <br /> 85 94 CLAY <br /> 94 115 SAND <br /> 115 180 CLAY <br /> 180 182 SAND <br /> 182 223 CLAY <br /> 223 225 SAND <br /> 225 248 CLAY <br /> 248 254 SAND <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />