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259 267 CLAY <br /> 2,67 268 SAND <br /> 268 301 CLAY <br /> 301 313 SAND <br /> 313 330 CLAY <br /> Casings <br /> Casing Depth from Surface Wall Outside Slot SizeScreen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 260 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 2 260 280 Screen PVC OD:8.625 in. I SDR: 0.41 8.625 Saw 0.045 <br /> 21 i Thickness:0.410 Cut <br /> in. <br /> 3 280 300 Blank PVC OD: 8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 4 300 320 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 Bentonite High Solids <br /> 200 1 320 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 /> 0330 14 Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 12/20/2021 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_03337.pdf-Permit CSG# State Well Number= <br /> umber Site Code Local Well Number <br /> 23243 Lone Tree Rd Escalon.pdf-Location Map <br /> NF-T Tl 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 />