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Borehole SpeciflcatiotasCertlfiction <br /> Depth from 1.the undersigned,certify that Uds report is complete and accurate to the best or 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 02/15/2022 290813 <br /> C-57 Licensed Water Well Contractor Date Signed G57 License Number <br /> rEz 4' ` .. <br /> CSG tt State Well Number Site Code Local Well Number <br /> N I I I 1w] <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page_I of 2 <br />