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655 758 Clay with Sand and Gravel Layers <br />758 895 Cemented Clay with Rock <br />895 920 Clay with Sand Layers <br />920 940 Rock <br />Casings <br />Casing <br />Depth from Surface <br />Fill Type Details <br />Filter Pack Size <br />Description <br />Wall <br />Outside <br />Screen <br />Slot Size <br />Person, Firm or Corporation <br /># <br />Feet to Feet <br />Casing Type <br />Material <br />Casings Specificatons <br />Thickness <br />Diameter <br />Type <br />if any <br />Description <br />Address City State Zip <br />(inches) <br />(inches) <br />(inches) <br />1 <br />0 <br />50 <br />Conductor or <br />Low Carbon <br />Grade: ASTM A53 <br />0.375 <br />30 <br />Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br />Conductor casing <br />TRS: <br />APN: <br />Fill Pipe <br />Steel <br />cemented in place. <br />2 <br />0 <br />420 <br />Blank <br />Low Carbon <br />Grade: ASTM A53 <br />0.312 <br />16 <br />Steel <br />2 <br />420 <br />440 <br />Blank <br />Low Carbon <br />Grade: ASTM A53 <br />0.312 <br />16 <br />Expansion Joint <br />Steel <br />2 <br />440 <br />480 <br />Blank <br />Low Carbon <br />Grade: ASTM A53 <br />0.312 <br />16 <br />Steel <br />2 <br />480 <br />920 <br />Screen <br />Low Carbon <br />Grade: ASTM A53 <br />0.312 <br />16 <br />Louver <br />0.09 <br />Standard -Flo Louvered <br />Steel <br />3 <br />0 <br />1 220 <br />1 Conductor or <br />Low Carbon <br />Grade: ASTM A53 <br />0.216 <br />3.5 <br />Gravel Feed Pipe <br />Fill Pipe <br />Steel <br />Annular Material <br />Depth from <br />Surface <br />Feet to Feet <br />Fill <br />Fill Type Details <br />Filter Pack Size <br />Description <br />0 50 <br />Cement <br />10.3 Sack Mix <br />Person, Firm or Corporation <br />0 200 <br />Cement <br />10.3 Sack Mix <br />200 940 <br />Filter Pack <br />Other Gravel Pack <br />#6 <br />Sierra Silica #6 <br />Other Observations: <br />Borehole Specifications <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Surface <br />Borehole Diameter (inches) <br />Name STONEHOUSE WELL DRILLING <br />Feet to Feet <br />Person, Firm or Corporation <br />0 <br />50 <br />36 <br />7801 LAKESIDE DRIVE RENO NV 89511 <br />50 <br />940 <br />24 <br />Address City State Zip <br />Signed electronic signature received 06/21/2022 904639 <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�F i i I W <br />_F <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 />