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Casings; <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> €f Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 400 Blank PVC OD:8.625 in.I SDR: 0.41 8.625 <br /> 211 Thickness:0.410 <br /> in. <br /> 1 400 420 Screen PVC OD:8.625 in.I SDR: 0.41 8.625 Saw 0.05 <br /> 211 Thickness:0.410 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 210 Bentonite High Solids <br /> 210 1 420 Filter Pack Other Gravel Pack No 6 sand <br /> Other Observations: <br /> well collapsed during development at approximately 200'+or-.Tried to retrieve casing and save well. <br /> Well to be abandoned at a later date. <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 /> 0 420 14 Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 12/16/2019 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 />