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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 7/21/2021 <br />WCR2021-009133 <br />Owner's Well Number Date Work Began 04/22/2021 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0041801 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name MARY FRANZIA <br />Mailing Address 20100 ZUMWALT RD <br />City ESCALON State CA Zip 95320 II <br />Date Work Ended 04/22/2021 <br />Permit Date 03/11/2021 <br />Former Use <br />Activity Destroy <br />Former Use Water Supply <br />Well Location <br />Address 20655 AYERS RD APN 205-090-380 <br />City ESCALON Zip 95320 County San Joaquin Township 01 S <br />Latitude 37 48 41.4612 N Longitude -120 3 24.2999 W Range 17 E <br />Section 36 <br />Deg. Min. Sec. Deg. Min. Sec. <br />Baseline Meridian Mount Diablo <br />Dec. Lat. 37.811517 Dec. Long. -120.05675 <br />Ground Surface Elevation 90 <br />Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown <br />Location Accuracy Unknown Location Determination Method GPS Elevation Determination Method Digital Aerial Photo <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 04/22/2021 <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 60 Feet <br />*May not be representative of a well's long term yield. <br />Destruction Details: <br />FILLED WITH BENTONITE AND CAPPED WITH A 3 FT MUSHROOM CAP. INSPECTED BY: NASEEM AT THE COUNTY 04.22.21 <br />Other Observations: <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />