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254 330 CLAY <br /> f <br /> 330 355 COARSE SAND&GRAVEL <br /> 355 363 CLAY <br /> 363 378 GRAVEL&SAND <br /> 378 415 CLAY <br /> Casings <br /> Casing De.0 from Surface Wall outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thlcknaa eOlarneter it any description <br /> (inches) (inches) Type (inches) <br /> 1 0 325 Blank PVC OD:12.750 in. I SDR: 0.606 12.75 <br /> 21 j Thickness:0.606 <br /> in_ <br /> 2 325 3885 Screen PVC QD:12.750 in. I SDR- 0.6066 T12.75 Saw 0.045 <br /> 21 1 Thickness. 0.606 Cut <br /> in, <br /> AP1nutar Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 208 Bentonite High Solids <br /> 208 1 385 Other Fill See description. BIRDS EYE GRAVEL <br /> Other Observations- <br /> Borehole Specifications Certification Statement <br /> Depth from the undersigned,canny treat tress repon a cu Clete ane a mte to the aeu or nv krowWdge and baW <br /> Surface Borehole Diameter(inches) Name MASELLIS DRILLING INC <br /> Feet to Feet <br /> 4 415 21 Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City Stata 21P <br /> Signed electronic signature received 07/2012021 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_026BS.pdf-Permit CSG# State Well NumberSita Code Local Well Number <br /> 17050 Lone Tree Rd Escalon.pdf-Location Map IT I I <br /> i I i _1 <br /> :EN F W <br /> Latitude Deg/Min]Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev, 1 211 912 01 7 Page 2 of 2 <br />