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Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type If any Description <br /> (inches) (inches) (inches) <br /> Anlnula ater�al �! �. , <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> Destruction Details: <br /> Test hole drilled to a depth of 260ft,back filled with native soil to 150ft.Pumped bentonite from 150ft to ground level,buried with native soil. <br /> Other Observations: <br /> ;.:. -,-, .,.:4._-,.t.: '„i.,..., _.u.�.,t. _u.,♦r>.”..t aea�,ct,...airfll..:.,,c+,`.a.,d-.,;,ioz' .t.# ,� ,....;��.t?.__.....,>,....... ,..a_.Sr.� .-..i. ._.,. .;r+ s�:,_� '.xa4l;M.„C s a. : x�.�::"r. �BoreholeSns � �f�c ut nrst#ti" k;. <br /> Depth from t,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 /> Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 05/06/2021 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> �.`� 7a' Is < "!' rj'`Fag nWQ ■■ N r .Ta,r>. r: ?i ft i <br /> SSY <br /> CSG# State Well Number Site Code Local Well Number <br /> N W <br /> Latitude Deg/Min/Sec Longitude DegiMin/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />