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T" - . 10 <br />CEIvVD <br />State of California <br />Well Completion Report <br />111,ALTtI1 Form DWR 188 Submitted 9/29/2022 <br />�� lli(���1L'` 1 r`I J WCR2022-011380 <br />I., <br />g11 1' 1�if <br />Owner's Well Number Date Work Began 09/22/2022 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP004378 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name GAYLORD HORNEY <br />Mailing Address 21934 HENRY RD. <br />City ESCALON State CA Zip 95320 <br />Well Location <br />Date Work Ended 09/23/2022 <br />Permit Date 08/24/2022 <br />Planned Use and Activity <br />Activity New Well <br />Planned Use Water Supply Domestic <br />Address 21934 HENRY RD APN 249-080-040 <br />City ESCALON Zip 95320 County San Joaquin Township 02S <br />Latitude 37 45 37.5048 N Longitude -120 56 25.6991 W Range 09 E <br />Section 13 <br />Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br />Dec. Lat. 37.760418 Dec. Long. -120.940472 Ground Surface Elevation 132 <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 Water Level and Yield of Completed Well <br />Orientation Vertical Specify Depth to first water (Feet below surface) <br />Depth to Static <br />Drilling Method Direct Rotary Drilling Fluid Bentonite <br />Water Level 74 (Feet) Date Measured 09/23/2022 <br />Estimated Yield; (GPM) Test Type Air Lift <br />Total Depth of Boring 295 Feet <br />Test Length (Hours) Total Drawdown (feet) <br />Total Depth of Completed Well 263 Feet `May not be representative of a well's long term yield. <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />