Laserfiche WebLink
a aft <br /> .;.,5{ f3 �``.S� _ �:., �• <br /> o ehole:S eciflcations CerifcaE�o Stafemeint r <br /> . : p n Ia <br /> f .�,` rt t _:T' <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the Fest 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 <br /> Signed electronic signature received 04/13/2021 290813 <br /> C-57 Licensed Water Well Contractor Date Signed G57 License Number <br /> CSG# State Well Number Site Code Local Well Number <br /> N W <br /> Latitude DeglMinlSec Longitude DeglMinlSec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />