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186 222 CLAY <br /> 222 224 SAND <br /> 224 250 CLAY <br /> 250 267 SAND <br /> 267 1 270 1 SHALE <br /> Casings <br /> Casing Depth from Surface wall Outside Casing Slot Size <br /> Type Material Casings S Screen <br /> # Feet to Feet g T yp 9 pecificatons Thickness Diameter if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 240 Blank PVC OD:6.900 in.I SDR: 0.329 6.9 <br /> 21 i Thickness:0.329 <br /> in. <br /> 2 240 260 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 /> 0 200 Bentonite High Solids <br /> 200 1 260 Other Fill See description. BIRDS EYE GRAVEL <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certdy 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 /> 0 270 11 Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 03/19/2024 668622 <br /> C-57 Licensed Water Well Contractor Dale Signed C-57 License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <br /> I i-T-N ] I I I I I 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 />