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290 314 BLUE CLAY <br /> 314 328 SAND <br /> 328 334 BLUE CLAY <br /> 334 338 SAND <br /> 338 360 1 BLUE CLAY <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 250 Blank PVC OD: 12.750 in. I SDR: 0.606 12.75 <br /> 21 1 Thickness:0.606 <br /> in. <br /> 2 250 350 Screen PVC OD: 12.750 in. I SDR: 0.606 12.75 Saw 0.045 <br /> 21 1 Thickness:0.606 Cut <br /> tin. <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 /> 200 350 Other Fill See description. BIRDS EYE GRAVEL <br /> Lt!bservations: <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 1 360 20 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 11/10/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> 24975 S.Austin Rd Ripon.pdf-Location Map CSG# State Well Number =Site Code Local Well Number <br /> Image_01699.pdf-Permit <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 />