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338 <br />342 <br />BROWN CLAY <br />342 <br />360 <br />SAND <br />360 <br />366 <br />BROWN CLAY <br />366 <br />385 <br />SAND <br />385 <br />433 <br />BROWN CLAY <br />433 <br />437 <br />SAND <br />437 <br />470 <br />BROWN CLAY <br />470 <br />477 <br />SAN D <br />477 <br />490 <br />BROWN CLAY <br />490 <br />503 <br />SAND <br />503 <br />524 <br />BROWN CLAY <br />524 <br />528 <br />SAND <br />528 <br />590 <br />BROWN CLAY <br />590 <br />593 <br />SAN D <br />593 <br />700 <br />BROWN CLAY <br />700 <br />810 <br />BLUE CLAY <br />Casings <br />Casing <br />Depth from Surface <br />Casing Type <br />Material <br />Casings Specificatons <br />Wall <br />Thickness <br />Outside <br />Diameter <br />Screen <br />Slot Size <br />if any <br />Description <br /># <br />Feet to Feet <br />(inches) <br />(inches) <br />Type <br />(inches) <br />Annular Material <br />Depth from <br />Surface <br />Fill <br />Fill Type Details <br />Filter Pack Size <br />Description <br />Feet to Feet <br />0 1 810 <br />Cement <br />10.3 Sack Mix <br />Destruction Details: <br />Ran tremie pipe to depth of 810 ft. pumped 13 yards 10.3 sak cement. <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 QUALITY WELL DRILLERS <br />Feet to Feet <br />Person, Firm or Corporation <br />0 810 <br />8 <br />260 AIR PARK RD ATWATER CA 95301 <br />Address City State Zip <br />Signed electronic signature received 05/14/2018 468732 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />DWR Use Only <br />P!L# <br />State Well Number <br />Site Code <br />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 />