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255 ' 266 SAND <br /> 266 272 CLAY <br /> 272 275 SAND <br /> 275 283 CLAY <br /> 283 285 SAND <br /> 285 292 CLAY <br /> 292 295 SAND <br /> 295 300 CLAY <br /> Casings <br /> Casing Depth from Surface Wall Outside Slot Size <br /> Casing Type Material Casings Specificatons Thickness Diameter Screen if any Description <br /> # Feet to Feat (inches) (inches) Type (inches) <br /> 1 0 260 Blank PVC OD:6.900 in.I SDR: 0.329 6.9 <br /> 21 1 Thickness:0.329 <br /> in. <br /> 2 260 300 Screen PVC OD:6.900 in.I SDR: 0.329 6.9 Saw 0.045 <br /> 21 1 Thickness:0.329 Cut <br /> in. <br /> ntillar Material <br /> Depth from <br /> Surface Fill Fill Type Details Fitter Pack Size Description <br /> Feet to Feet <br /> 0 200 Bentonite High Solids <br /> 200 1 300 Other Fill See description. GRIT SAND <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,ceitty 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 /> 0 300 11 Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 08/28/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed -57 License Number <br /> Attachments DWR Use Only <br /> Image_01373.pdf-Permit CSG# State Well Number Site Code Local Well Number <br /> ETN] El IiTw l <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 />