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WP0041375
EnvironmentalHealth
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NORTH RIPON
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20310
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041375
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Entry Properties
Last modified
12/28/2021 4:47:57 PM
Creation date
9/15/2021 1:30:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041375
PE
4369
STREET_NUMBER
20310
Direction
S
STREET_NAME
NORTH RIPON
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
24515051
ENTERED_DATE
10/27/2020 12:00:00 AM
SITE_LOCATION
20310 S NORTH RIPON RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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253.. <br />254 <br />SAND <br />254 <br />273 <br />CLAY <br />273 <br />279 <br />SAND <br />279 <br />308 <br />CLAY <br />308 <br />318 <br />SAND <br />318 1 <br />370 <br />CLAY <br />Other Observations: <br />Casings <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Casing <br />Depth from Surface <br />Casing Type <br />Material <br />Casings Specificatons <br />Wall <br />Thickness <br />Outside <br />Diameter <br />Screen <br />Slot Size <br />if any <br />Description <br /># <br />Feet to Feet <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />DWR Use Only <br />(inches) <br />(inches) <br />Type <br />(inches) <br />Site Code Local Well Number <br />1 <br />0 <br />184 <br />Blank <br />PVC <br />OD: 12.750 in. I SDR: <br />0.606 <br />12.75 <br />Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br />TRS: <br />APN: <br />21 1 Thickness: 0.606 <br />in. <br />2 <br />184 <br />324 <br />Screen <br />PVC <br />OD: 12.750 in. I SDR: <br />0.606 <br />12.75 <br />Saw <br />0.045 <br />21 1 Thickness: 0.606 <br />Cut <br />in. <br />Annular Material <br />Depth from <br />Surface <br />Fill <br />Fill Type Details <br />Filter Pack <br />Size <br />Description <br />Feet to Feet <br />0 <br />108 <br />Bentonite <br />High Solids <br />108 <br />324 <br />Other Fill <br />See description. <br />BIRDS EYE GRAVEL <br />Other Observations: <br />Borehole Specifications <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Surface Borehole Diameter (inches) <br />Name MASELLIS DRILLING INC <br />Feet to Feet <br />Person, Firm or Corporation <br />0 370 21 <br />119 ALBERS ROAD MODESTO CA 95357 <br />Address City State Zip <br />Signed electronic signature received 07/20/2021 668622 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />DWR Use Only <br />Attachments <br />20310 S North Ripon Rd Ripon.pdf - Location Map <br />CSG <br />WT -Stat, Well Number <br />Site Code Local Well Number <br />Image_02659.pdf - Permit <br />N FW] <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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