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WP0039981
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039981
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Last modified
12/27/2021 2:31:28 PM
Creation date
12/19/2019 1:25:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039981
PE
4378
STREET_NUMBER
19012
Direction
S
STREET_NAME
CALLA
STREET_TYPE
DR
City
MANTECA
Zip
95336-
APN
22803048
ENTERED_DATE
8/20/2019 12:00:00 AM
SITE_LOCATION
19012 S CALLA DR
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2019
Tags
EHD - Public
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280 , 300 1 SAND <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 280 Blank PVC OD:6.625 in. I SDR: 0.316 6.625 <br /> 21 1 Thickness:0.316 <br /> in. <br /> 2 280 300 Screen PVC OD:6.625 in. I SDR: 0.316 6.625 Saw 0.045 <br /> 21 1 Thickness:0.316 Cut <br /> in. <br /> Annular 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 1 300 Other Fill See description. GRIT SAND <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 MASELLIS DRILLING INC <br /> Feet to Feet <br /> 0 1 300 11 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 12/11/2019 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> 19012 S.Calla Dr.Manteca.pdf-Location Map CSG# State Well Number =Site Code Local Well Number <br /> Image_00489.pdf-Permit <br /> N [:FLE=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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