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214 221 Gravel <br /> 221 225 Sand <br /> 225 234 Clay <br /> 234 258 Sand-coarse <br /> 258 259 Clay <br /> 259 265 Sand-coarse <br /> 265 267 Sand-fine <br /> 267 280 Sand-coarse <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> q 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.)SDR: 0.332 8.625 <br /> 26)Thickness:0.332 <br /> in. <br /> 1 260 280 Screen PVC OD:8.625 in.)SDR: 0.41 8.625 Saw 0.085 <br /> 21 1 Thickness:0.410 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface FIII Fill Type Details Filter Pack Size Description <br /> Feel to Feet <br /> 0 104 Bentonite High Solids <br /> 104 1 280 Filter Pack Other Gravel Pack No 6 sand pack <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 HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> 0 280 14 Person,Firm or Corporation <br /> 1930 I.ADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 06/06/2018 290813 <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 />