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Borehole Specifications Cerkification Statement E' <br /> v,.- :r: wf.,. .. :,:a?.. xi_ _i., ,u_x .e.._.c1-, 3..k.lf:,.. ..e a7,av2,.,Nrc.�yc .,r+. .:. r„�iS; •,a;r. .sus, <br /> Depth from 1,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 <br /> Signed electronic signature received 11/19/2021 290813 <br /> C-57 Licensed Water Well ConorDate Signed C,57 License Number <br /> 4 3 Yf DWS\Use Oni1 i i <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 />