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State of California Well Completion Report Form DWR 188 Submitted 7/19/2021 WCR2021-009006 Owner's Well Number Date Work Began 11/10/2020 Date Work Ended 11/12/2020 Local Permit Agency San Joaquin County Environmental Health Department Secondary Permit Agency Permit Number WP0041295 Permit Date 10/11/2020 Well Owner (must remain confidential pursuant to Water Code 13752) Planned Use and Activity Name VINCE CIPPONERI Activity New Well Mailing Address PO BOX 630 Planned Use Water Supply Domestic City ESCALON State CA Zip 95320 Well Location Address 8615 S VIA CARANO PL APN 187-400-320 City ESCALON Zip 95320 County San Joaquin Township 01 N Latitude 37 53 26.4768 N Longitude -120 57 43.2719 W Range 09 E Section 35 Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo Dec.Lat. 37.890688 Dec.Long. -120.96202 Ground Surface Elevation 151 Vertical Datum Horizontal Datum WGS84 Elevation Accuracy Unknown Location Accuracy Unknown Location Determination Method Other Elevation Determination Method Digital Aerial Photo Borehole Information Water Level and Yield of Completed Well Orientation Vertical Specify Depth to first water (Feet below surface) Drilling Method Direct Rotary Drilling Fluid Bentonite Depth to Static Water Level 154 (Feet) Date Measured 11/12/2020 Total Depth of Boring 320 Feet Estimated Yield* (GPM) Test Type Air Lift Test Length (Hours) Total Drawdown (feet) Total Depth of Completed Well 320 Feet *May not be representative of a well's long term yield. Geologic Log - Free Form Depth from Surface Description Feet to Feet 0 3 TOP SOIL 3 13 SHALE 13 27 SAND 27 38 SHALE 38 55 SAND&GRAVEL 55 138 SHALE 138 144 BLACK SAND 144 154 SHALE 154 169 BLACK SAND 169 193 SHALE 193 229 SHALE 229 231 BLACK SAND 231 253 SHALE 253 256 BLACK SAND 256 287 SHALE Form DWR 188 rev. 12/19/2017 Page 1 of 2