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,.:=.s i+ F `a, Ft' '� c:i a• S y.,.w i5.,s sr"Iab-- YtJadcy thS' rc�t'aF},' .sa .:�srJ Cw�l.,-�:.;.tk a t' <br /> i{tr tta Casio S° �:itfTc. '4` €.z s y <br /> .., .. ...... t�.......... .-.. ,,.:s.c..a.:«w skxs&,3"i- ."..r�';:,A!':!'d � - <br /> SS1 t <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 /> 1 0 260 Blank PVC OD:8.625 in.I SDR: 0.41 8.625 <br /> 211 Thickness:0.410 <br /> in. <br /> 1 260 300 Screen PVC OD:8.625 in.I SDR: 0.41 8.625 Saw 0.05 <br /> 211 Thickness:0.410 Cut <br /> in. <br /> 43 M7 "t L`'s`1. P' ?i S <br /> :.•.': ,>, �. rou -a. 2�.... .i...::.:...,�...,_..,..a*."....:.. <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 1 300 Filter Pack Other Gravel Pack No 6 sand pack <br /> Other Observations: <br /> ';a b:.,m:e :E1 .i S> SZ<.. x.1,1rtsy t. t`Y. (a.1Gcs <br /> Bblreirol..�$pscifi�ato°ns} t; a �aGerEifiea�toi # ie ? �, ' <br /> Depth from i.the undersigned,certify that this report Is complete and aocurate to the best or my knowledge and belief <br /> Surface Borehole Diameter(inches) Name HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> 0 300 14 Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 08/08/2022 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 license Number <br /> YYFi�,;tSe)i�[liy`s <br /> CSG#j 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 /> =orm DWR 188 rev. 12/19/2017 Page 2 of 2 <br />