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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 10/9/2023 <br /> WCR2023-011047 <br /> Owner's Well Number Date Work Began 10/05/2023 Date Work Ended 10/05/2023 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number 44440 Permit Date 04118/2023 <br /> j�, <br /> Well Owner most c6infidefilia''hr s <br /> 6ulua",W, <br /> Name Maria Olivia Activity Destroy <br /> Mailing Address 250 Maple Ave. Former Use Water Supply <br /> City Ripon State CA Zip 95366 <br /> N <br /> ,W <br /> Address 250 Maple AVE APN 259-03-005 <br /> City Ripon Zip 95366 County San Joaquin Township 02S <br /> Latitude 37 44 28.384 N Longitude -121 7 53.7337 W Range 08 E <br /> Section 19 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.7412178 Dec.Long. -121.1315927 Ground Surface Elevation <br /> Vertical Datum Horizontal Datum WGS84 Elevation Accuracy <br /> Location Accuracy Location Determination Elevation Determination Method <br /> Method <br /> � Completed Well Borehole,Ifformatibn" <br /> WaterLevetLan o <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Drilling Fluid Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring Feet Estimated Yield* (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 60 Feet •May not be representative of a well's long term yield. <br /> Destruction Details: <br /> No pump in old steel 6in well that is located in a building. <br /> Hand carried buckets of hole plug bentonite pellets mixed with water to seal off old well. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />