Laserfiche WebLink
Borehole.S eclficat ons t <br /> p .; 1,�,,. i;Certfication Statement y <br /> .,.qi ,ri.erltrae. ,.7 z!^ ne. ,.a: •.F...E+ <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 HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 11/25/2020 290813 <br /> C-57 Licensed Water Well Contractor Date Signed 757 License Number <br /> f DWk-Use Qnlyit z. ; <br /> .. t KF{ �3iN... S,ISe f:. `!, S.. el- ._ EI. fig .S <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 2 of 2 <br />