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F SERVREQ SERVICE REQUEST Facility ID Facility Name Record ID 013568 , Location 3440 E . MAIN ST. , STKN eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee Property Owner SOHAIL & KHAIL BAFAIZ Business Name PARTNERSHIP Street Number Dir Street Name Type Unit 834 _ HANCOCK ST 3 2nd Address ULTRAMAR, 325 THIRD ST, HANFORD 93232 City HAYWOOD, State CA Zip 94544- Phone 1 - - Ext APN 157-160-02 Phone 2 - - Ext Census 000001 District 001 Location 01 Citycode Requestor KEN MATIEK, RG/HORIZON for Business Name V & W DRILLING, C-57 #720904 Address 1 PO BOX 51 Address 2 City RIO VISTA State CA Zip - Phone Number 707-374-2815 Ext Nature of Service Request - ON SITE BORING PERMIT FOR FOUR (4) NEW MONITORING WELLS (6 , 7, 8 , AND 9) AND TWO SOIL BORINGS (SB-5 AND 6) UNDER APPROVED WORK- F=Find E=Enter U=Update D=Delete Page 1 9 :36 : 54a F SERVREQ SERVICE REQUEST .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee Comments - PLAN BY LOP/MI . HORIZON CHECK #1454 SUBMITTED ON 9/4/97 . Name Date Time Received By 0684 INFURNA, MICHAE 09/04/97 Assigned To 0684 INFURNA, MICHAE 09/08/97 Date Service Completed _/_/_ Requires Further Action Y/N Y Amount paid 89 . 00 Program/Element 3501 Due date Oaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa� ° This record was entered on 09/08/9.7 By STAFF ° ° This record was last updated on 09/08/97 By STAFF ° aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaai F=Find E=Enter U=Update D=Delete Page 2