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WP0042570
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042570
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Entry Properties
Last modified
3/16/2022 1:26:26 PM
Creation date
2/7/2022 9:31:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042570
PE
4373
STREET_NUMBER
201
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00310015
ENTERED_DATE
9/20/2021 12:00:00 AM
SITE_LOCATION
201 E JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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- Borehole Specifications' `'� `.' �- ` � Certification'Stateineiit F: ' �r ' , <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the beat 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 02/01/2022 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> I4 , tr <br /> y <br /> CSG# State Well Number Site Code Local Well Number <br /> N Lw <br /> Latitude Deg/Min/See 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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