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290 296 SAND <br /> 296 318 SHALE <br /> 318 320 SET UP GRAVEL <br /> 320 333 SHALE <br /> 333 335 SAND <br /> 335 360 SHALE <br /> 360 362 SAND <br /> 362 383 SHALE <br /> 383 393 SAND <br /> 393 430 SHALE <br /> Casings <br /> Slot Sizeid <br /> t <br /> Wall Ouse <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Speclficatons Thickness Diameter if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 360 Blank PVC OD:6.625 in. I SDR: 0.316 6.625 <br /> 21 1 Thickness:0.316 <br /> in. <br /> 2 360 400 Screen PVC OD:6.625 in. I SDR: 0.316 6.625Saw 0.045 <br /> 21 1 Thickness:0.316 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 100 Bentonite High Solids <br /> 100 1 400 Other Fill See description. GRAVEL <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 MASELLIS DRILLING INC <br /> Feet to Feet <br /> 0 1 430 11 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 08/30/2019 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_00202.pdf-Permit CSG# State Well Number Site Code Local Well Number <br /> 21750 E. Brandt Rd-Robidart.pdf-Location Map <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 />