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. Casings <br /> Casing Depth from Surface Wall Outside Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Screen <br /> if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 280 Blank PVC OD:6.900 in.I SDR: 0.329 6.9 <br /> 21 Thickness:0 9 <br /> in. <br /> 2 280 300 Screen PVC OD:6.900 in. SDI: 0.329 6.9 Saw 0.045 <br /> in Thickness:0. 9L Cut <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size <br /> Feet to Feet Description <br /> 0 200 Bentonite High Solids <br /> 200 1 300 Other Fill See description. <br /> 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 <br /> Feet to Feet MASELLIS DRILLING INC <br /> 0 315 11 Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 10/14/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> 25682 E Mahon Ave Escalon.pdf-Location Map CSG# State Well Number Site Code Local Well Number <br /> Image_016!1.pdf-Photo <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 />