Each report shall be prepared on a form provided by the board. The report shall include all of the following information:

1. (a) The name and address of the person who extracted groundwater and of the person filing the report.
2. (b) The name of the basin from which groundwater was extracted.
3. (c) The place of groundwater extraction. The location of the groundwater extraction facilities shall be depicted on a specific United States Geological Survey topographic map or shall be identified using the California Coordinate System or a latitude and longitude measurement. If assigned, the public land description to the nearest 40-acre subdivision and the assessor’s parcel number shall be provided.
4. (d) The capacity of the groundwater extraction facilities.
5. (e) Monthly records of groundwater extractions. The measurements of the extractions shall be made by a methodology, water-measuring device, or combination thereof satisfactory to the board.
6. (f) The purpose of use.
7. (g) A general description of the area in which the water was used. The location of the place of use shall be depicted on a specific United States Geological Survey topographic map or on any other maps with identifiable landmarks. If assigned, the public land description to the nearest 40-acre subdivision and the assessor’s parcel number shall also be provided.
8. (h) As near as is known, the year in which the groundwater extraction was commenced.
9. (i) Any information required pursuant to paragraph (3) of subdivision (c) of Section 10735.2.
10. (j) Any other information that the board may require by regulation and that is reasonably necessary for purposes of this division or Part 2.74 (commencing with Section 10720) of Division 6.