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WP0040057
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040057
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Entry Properties
Last modified
12/19/2019 1:42:56 PM
Creation date
10/22/2019 2:43:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040057
PE
4370
STREET_NUMBER
26891
Direction
E
STREET_NAME
MAHON
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
22740011
ENTERED_DATE
9/9/2019 12:00:00 AM
SITE_LOCATION
26891 E MAHON AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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263 271 CLAY <br /> 271 273 SAND <br /> 273 325 CLAY <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Tif any Description <br /> Type(inches) (inches) (inches) <br /> 1 0 255 Blank PVC OD:6.625 in. I SDR: 0.316 6.625 <br /> 21 1 Thickness:0.316 <br /> in. <br /> 2 255 275 Screen PVC OD:6.625 in. I SDR: 0.316 6.625 Saw 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 /> 0 200 Bentonite High Solids <br /> 200 1 275 Other Fill See description. GRIT SAND <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 1 325 11 <br /> Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 09/19/2019 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_00246.pdf-Photo CSG# State Well Number Site Code Local Well Number <br /> 26891 Mahon Rd Escalon.pdf-Location Map <br /> N UW <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 />
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