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State of California <br /> Well Completion Report <br /> Form DWR 188 Submitted 5/7/2019 <br /> WCR2019-006251 <br /> Owner's Well Number d1 Date Work Began 04/26/2019 Date Work Ended 04/29/2019 <br /> Local Permit Agency San Joaquin County Environmental Health Department <br /> Secondary Permit Agency Permit Number WP0039522 Permit Date 04/18/2019 <br /> Well Owner (must remain confidential pursuant to Water Code 13752) Former Use <br /> Name OLLIIX LLC, Activity Destroy <br /> Mailing Address 45875 Northport Loop East Former Use Water Supply <br /> City Fremont State CA Zip 94538 <br /> Well Location <br /> Address APN 212-160-170-000 <br /> City Zip County San Joaquin Township 02S <br /> Latitude 37 44 27 N Longitude -121 25 22 W Range 05 E <br /> Section 21 <br /> Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br /> Dec.Lat. 37.7408333 Dec.Long. -121.4227778 Ground Surface Elevation 13 <br /> Vertical Datum NGVD29 Horizontal Datum NAD27 Elevation Accuracy 10 Ft <br /> Location Accuracy 5 Ft Location Determination Method Digital Elevation Elevation Determination Method Digital Aerial Photo <br /> Borehole Information Water Level and Yield of Completed Well <br /> Orientation Vertical Specify Depth to first water (Feet below surface) <br /> Drilling Method Drilling Fluid Depth to Static <br /> Water Level 0.5 (Feet) Date Measured 04/29/2019 <br /> Total Depth of Boring Feet Estimated Yield* (GPM) Test Type <br /> Test Length (Hours) Total Drawdown (feet) <br /> Total Depth of Completed Well 12 Feet *May not be representative of a well's long term yield. <br /> Destruction Details: <br /> 8V steel well casing in very bad shape from grade to 12'below grade. Cleared well to 31'below grade. Open bore filled with sand from 12'to 31'. Placed <br /> tremie pipe to 12'. Pump tremie placed 6-sack concrete from 12'below grade to 5'below grade. Dug down 5'and removed casing at 5'. Placed 6-sack <br /> concrete"cap"over the top of the well casing. Backfilled with native soil. <br /> Other Observations: <br /> Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />