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State of California <br />Well Completion Report <br />Form DWR 188 Submitted 8/8/2022 <br />WCR2022-009175 <br />Owner's Well Number Date Work Began 09/17/2021 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number WP0042114 <br />Well Owner (must remain confidential pursuant to Water Code 13752) <br />Name ROBERT MATHIAS <br />Mailing Address 17327 S. VAN ALLEN RD. <br />City ESCALON <br />State CA Zip 95320 <br />Well Location <br />Date Work Ended 09/17/2021 <br />Permit Date 06/02/2021 <br />Planned Use and Activity <br />Activity New Well <br />Planned Use Water Supply Irrigation - <br />Agriculture <br />Address 17327 S VAN ALLEN RD APN 205-080-260 <br />City ESCALON Zip 95320 County San Joaquin Township 01S <br />Latitude 37 48 13.8059 N Longitude -121 3 17.2079 W Range 08 E <br />Section 35 <br />Deg. Min. Sec. Deg. Min. Sec. Baseline Meridian Mount Diablo <br />Dec. Lat. 37.803835 Dec. Long. -121.05478 Ground Surface Elevation 99 <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 />Orientation Vertical <br />Drilling Method Direct Rotary Drilling Fluid <br />Specify <br />Bentonite <br />Water Level and Yield of Completed Well <br />Depth to first water (Feet below surface) <br />Depth to Static <br />Water Level 84 (Feet) Date Measured 09/17/2021 <br />Estimated Yield' (GPM) Test Type Air Lift <br />Test Length (Hours) Total Drawdown (feet) <br />'May not be representative of a well's long term yield. <br />Total Depth of Boring 390 Feet <br />Total Depth of Completed Well 380 Feet <br />Geologic Log - Free Form <br />Depth from <br />Surface <br />Feet to Feet <br />Description <br />0 6 <br />TOP SOIL <br />6 18 <br />SAND <br />18 20 <br />CLAY <br />20 29 <br />SAND <br />29 43 <br />CLAY <br />43 65 <br />SAND <br />65 69 <br />CLAY <br />69 84 <br />SAND <br />84 94 <br />CLAY <br />94 104 <br />SAND & GRAVEL <br />104 109 <br />CLAY <br />109 127 <br />SAND <br />127 176 <br />CLAY <br />176 180 <br />SAND <br />Form DWR 188 rev. 12/19/2017 Page 1 of 3 <br />