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245 249 Sand <br /> 249 280 Clay <br /> 280 283 Sand <br /> 283 325 Clay <br /> 325 350 Sand Gravely <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 330 Blank PVC OD:8.625 in. I SDR: 0.332 8.625 <br /> 26 1 Thickness:0.332 <br /> in. <br /> 1 330 350 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 /> 0 104 Bentonite Other Bentonite <br /> 104 1 350 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 /> 0350 14 Person, Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 07/31/2019 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 /> IN � FFJ I I I <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 />