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WP0041304
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041304
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Entry Properties
Last modified
12/27/2021 1:51:32 PM
Creation date
12/10/2020 3:48:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041304
PE
4370
STREET_NUMBER
17710
Direction
E
STREET_NAME
CEDAR
STREET_TYPE
LN
City
RIPON
Zip
95366-
APN
24514006
ENTERED_DATE
10/5/2020 12:00:00 AM
SITE_LOCATION
17710 E CEDAR LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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260• 265 CLAY <br /> 265 267 SAND <br /> 267 276 CLAY <br /> 276 283 SAND <br /> 283 300 1 CLAY <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 255 Blank PVC OD:6.900 in. I SDR: 0.329 6.9 <br /> 21 1 Thickness:0.329 <br /> in. <br /> 2 255 275 Screen PVC OD:6.900 in. I SDR: 0.329 6.9 Saw 0.045 <br /> 21 1 Thickness:0.329 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 200 Bentonite High Solids <br /> 200 1 275 Other Fill See description. GRIT SAND <br /> Other Observations: <br /> 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 /> 0 1 300 11 <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 10/26/2020 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Image_01674.pdf-Permit CSG# State Well Number Site Code Local Well Number <br /> 17710 E Cedar Ln Ripon.pdf-Location Map <br /> N I I I I I I I 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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