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} Casings , <br /> .kz. � ..r Y l. I <br /> Outside Casing Depth from Surface Wall OutsScreen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) yp (inches) <br /> 1 0 275 Blank PVC OD:8.625 in.I SDR: 0.41 8.625 <br /> 211 Thickness:0.410 <br /> in. <br /> 1 275 295 Screen PVC OD:8.625 in.I SDR: 0.41 8.625 Saw 0.05 <br /> 21 Thickness:0.410 Cut <br /> in. <br /> Anlnufar 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 /> 200 295 Filter Pack Other Gravel Pack No 6 sand pack <br /> Other Observations: <br /> Borehole Specificatiens ;; Certicat <br /> ifion;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 /> Person,Firm or Corporation <br /> 0 295 14 <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 10/13/2020 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> f <br /> DWR V se'Onty <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 />