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233 235 SHALE <br /> 235 241 SAND <br /> 241 246 SHALE <br /> 246 250 SAND <br /> 250 253 SHALE <br /> 253 255 SAND <br /> 255 264 SHALE <br /> 264 267 SAND <br /> 267 273 CLAY <br /> 273 276 SAND <br /> 276 345 SHALE <br /> Casings <br /> Casing Depth from Surface Wall Outside Slot Size <br /> Casing Type Material Casings S ecificatons Thickness Diameter Screen if an Description <br /> # Feet to Feet g p Y p <br /> (inches) (inches) Type (inches) <br /> 1 0 220 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 2 220 280 Screen PVCD:8.625 in.I SDR: 0.41 8.625 Saw 0.045 <br /> O <br /> J21 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 /> 200 280 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 /> .---TT345 14 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 04/19/2023 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 />