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WP0041214
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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9277
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041214
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Entry Properties
Last modified
11/19/2024 1:59:19 PM
Creation date
11/2/2020 2:11:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041214
PE
4373
STREET_NUMBER
9277
Direction
S
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95206-
APN
20102003
ENTERED_DATE
9/10/2020 12:00:00 AM
SITE_LOCATION
9277 S HWY 99
P_LOCATION
99
P_DISTRICT
001
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 10/01/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_01516.pdf-Permit CSG# State Well Number Site Code Local Well Number <br /> N L LCL] <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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