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WP0039458
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039458
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Entry Properties
Last modified
4/24/2019 4:08:17 PM
Creation date
3/25/2019 9:52:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039458
PE
4373
STREET_NUMBER
626
Direction
E
STREET_NAME
AUGUSTA
STREET_TYPE
ST
City
WOODBRIDGE
Zip
95258-
APN
01510025
ENTERED_DATE
3/15/2019 12:00:00 AM
SITE_LOCATION
626 E AUGUSTA ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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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 /> Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 03/22/2019 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 />
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