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184 203 Clay <br /> 203 221 Sand <br /> 221 225 Clay <br /> 225 232 Silty Sand <br /> 232 247 Sand <br /> 247 1 250 Clay <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specifications Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 230 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 1 230 250 Screen PVC OD:8.625 in.I SDR: 0.332 8.625 Saw 0.05 <br /> 26 1 Thickness:0.332 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 200 Bentonite Other Bentonite <br /> 200 1 250 Filter Pack Other Gravel Pack <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> 0 250 14 Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State zip <br /> Signed electronic signature received 03/21/2019 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <br /> N W <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />