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WP0040695
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040695
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Last modified
9/17/2020 2:27:11 PM
Creation date
9/17/2020 9:06:23 AM
Metadata
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Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040695
PE
4375
STREET_NUMBER
17831
Direction
S
STREET_NAME
MCKINLEY
STREET_TYPE
AVE
City
LATHROP
Zip
95330-
APN
19815008
ENTERED_DATE
4/2/2020 12:00:00 AM
SITE_LOCATION
17831 S MCKINLEY AVE
P_LOCATION
07
P_DISTRICT
003
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 ROADRUNNER DRILLING&PUMP COMPANY INC <br /> Feet to Feet <br /> 0 50 38 Person, Firm or Corporation <br /> 50 290 24 80 BEE JAY WAY WOODLAND CA 95776 <br /> Address City State Zip <br /> Signed electronic signature received 08/24/2020 803909 <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 3 of 3 <br />
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