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301 311 BLUE CLAY <br /> 311 315 SAND <br /> 315 347 BLUE CLAY <br /> 347 348 SAND <br /> 348 374 BLUE CLAY <br /> 374 378 BLUE SAND <br /> 378 400 BLUE CLAY <br /> Casings <br /> Casing Death from Surface Wall Outside Siot SizeScreen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Tif any Description <br /> Type(inches) (inches) (inches) <br /> 1 0 360 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 2 360 380 Screen PVC OD:8.625 in. I SDR: 0.41 8.625 Saw 0.045 <br /> 21 1 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 /> 0 200 Cement 10.3 Sack Mix <br /> 200 1 380 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 1 400 13.5 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State p <br /> Signed electronic signature received 08/26/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> 10350 S.McKinley Ave.pdf-Location Map CSG# State Well Number Site Code Local Well Number <br /> Image_01364.pdf-Permit <br /> -1 <br /> N � ED I I I 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 />