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01 <br /> Borehote Sped cations ' x Ce I�cattofi:State a I 1 \1 , <br /> __ � . <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 CANEPA AND SONS INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 14384 CUESTA COURT SONORA CA 95370 <br /> Address City State <br /> Signed electronic signature received 12/13/2021 425749 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> 01,1 <br /> CSG# State Well Number Site Code Local Well Number <br /> -I I 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 />