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,Boehote Ica 10 ` , ;erti°ation,S aieinent` <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 12/28/2021 425749 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />CSG # I State Well <br />Latitude Deg/Mi <br />TRS: <br />APN: <br />Site Code <br />Local Well Number <br />FW <br />Longitude Deg/Min/Sec <br />Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />