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WP0042588
EnvironmentalHealth
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4300 - Water Well Program
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WP0042588
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Last modified
8/8/2022 4:59:33 PM
Creation date
6/15/2022 4:40:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042588
PE
4378
STREET_NUMBER
25986
Direction
E
STREET_NAME
DOVE
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20720023
ENTERED_DATE
9/27/2021 12:00:00 AM
SITE_LOCATION
25986 E DOVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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238 1 265 1 CLAY <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 220 Blank PVC OD:6.900 in. I SDR: 0.329 6.9 <br /> 21 1 Thickness:0.329 <br /> in. <br /> 2 220 240 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 /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 100 Bentonite High Solids <br /> 100 240 Other Fill See description. BIRDS EYE GRAVEL <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 /> 0 265 11 Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 07/19/2022 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <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 />
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