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WP0040932
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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RIVER
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22339
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040932
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Entry Properties
Last modified
11/24/2021 2:39:50 PM
Creation date
7/22/2020 9:29:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040932
PE
4368
STREET_NUMBER
22339
Direction
E
STREET_NAME
RIVER
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
24525009
ENTERED_DATE
6/30/2020 12:00:00 AM
SITE_LOCATION
22339 E RIVER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
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 MASELLIS DRILLING INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 08/26/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_01_63.pdf-Permit CSG# State Well Number Site Code Local Well Number <br /> 22339 E River Rd.pdf-Location Map <br /> AN 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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