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r <br /> Depth from Surface <br /> Description <br /> (Feet to Feet) <br /> 79 93 SAND <br /> 93 124 CLAY <br /> 124 136 SAND <br /> 136 215 CLAY <br /> 215 221 SAND <br /> 221 240 CLAY <br /> %IM(,- 0. . �,` <br /> Casing Depth from Surface Casing Wall Outside Screen Slot Size if <br /> (Feet to Feet) Type <br /> Material Casings Specifications Thickness Diameter Type any Description <br /> (inches) (inches) (inches) <br /> OD:6.900 in.I SDR: <br /> 1 0 212 Blank PVC 211 Thickness:0.329 0.329 6.9 <br /> in. <br /> OD:6.900 in.I SDR: <br /> Saw <br /> 1 212 225 Screen PVC 211 Thickness:0.329 0.329 6.9 Cut 0.045 <br /> in. <br /> Annular Material <br /> Depth from Surface <br /> Fill Fill Type Details Filter Pack Size Description <br /> (Feet to Feet) <br /> 0 160 Bentonite High Solids <br /> 160 22S Other Fill See description GRAVEL#6 <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from Surface Borehole Diameter I,the undersigned,certify that this report is complete and accurate to the best of my knowledge <br /> (Feet to Feet) (Inches) and belief. <br /> 0 240 14 Name: MASELLIS DRILLING INC <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO California 9357 <br /> Address City State Zip <br /> Signed: electronic signature received 10/14/2025 668622 <br /> C-57 Licensed Water Well Contractor Date Signed License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <br /> DWR Form 188 rev 10/14/2025 Page 2 of 3 <br />