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I r <br />State of California <br />Well Completion Report <br />Form DWR 188 Submitted 7/27/2022 <br />WCR2022-008547 <br />Owner's Well Number Date Work Began 06/08/2021 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0042033 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name MARY ROCHE <br />Mailing Address 30163 HALL RD. <br />City ESCALON State CA Zip 95320 11 <br />Well Location <br />Date Work Ended 06/09/2021 <br />Permit Date 05/12/2021 <br />Former Use <br />Activity Destroy <br />Former Use Water Supply <br />Address 30163 HALL RD APN 249-080-100 <br />City ESCALON Zip 95320 County San Joaquin Township 02S <br />Latitude 37 45 33.2243 N Longitude -120 56 20.166 W Range 09 E <br />Section 13 <br />Deg. Min. Sec. Deg. Min. Sec. <br />Baseline Meridian Mount Diablo <br />Dec. Lat. 37.759229 Dec. Long. -120.938935 Ground Surface Elevation 129 <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 <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 06/09/2021 <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 Feet <br />*May not be representative of a well's long term yield. <br />Destruction Details: <br />6" x 80' WELL DESTRUCTION <br />INSPECTOR AARON <br />Other Observations: <br />Form DWR 188 rev. 12/19/2017 Page 1 of 2 <br />