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Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) if <br /> 1 0 150 Blank PVC OD:4.500 in. 1 0.337 4.5 SCH 80 <br /> Thickness:0.337 in. <br /> 1 150 160 Screen PVC OD:4.500 in. 1 0.337 4.5 Milled 0.04 SCH 80 <br /> Thickness:0.337 in. Slots <br /> 1 160 175 Blank PVC OD:4.500 in. 1 0.337 4.5 SCH 80 <br /> Thickness:0.337 in. <br /> 1 175 185 Screen PVC OD:4.500 in. 1 0.337 4.5 Milled 0.04 SCH 80 <br /> Thickness:0.337 in. Slots <br /> 1 185 187 No Casing Other N/A NO CASING <br /> Installed <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 124 Cement Other Cement NEAT CEMENT W/5%BENTONITE <br /> 124 128 Cement 10.3 Sack Mix CEMENT GROUT <br /> 128 129 Other Fill See description. FINE SAND TRANSITION SEAL <br /> 129 163 Filter Pack 8 x 16 GRAVEL ENVELOPE <br /> 163 168 Bentonite High Solids INTERMEDIATE SEAL <br /> 168 1 187 Filter Pack 8 x 16 GRAVEL ENVELOPE <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 WELL INDUSTRIES INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 0 187 12.25 <br /> 3282 HIGHWAY 32 CHICO CA 95973 <br /> Address City State Zip <br /> Signed electronic signature received 09/11/2018 812678 <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 />