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WP0041376
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041376
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Last modified
12/16/2022 2:37:17 PM
Creation date
3/10/2022 4:48:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041376
PE
4369
STREET_NUMBER
14466
Direction
E
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
18307002
ENTERED_DATE
10/27/2020 12:00:00 AM
SITE_LOCATION
14466 E MARIPOSA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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564 566 SAND <br /> 566 578 SHALE <br /> 578 598 SAND&GRAVEL <br /> 598 620 SHALE <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feel to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 300 Blank Low Carbon N/A 0.25 16 <br /> Steel <br /> 2 300 600 Screen Low Carbon N/A 025 16 Milled 0.09 <br /> Steel Slots <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 50 Cement 10.3 Sack Mix <br /> 50 1 600 Other Fill See description. BIRDS EYE GRAVEL <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name MASELLIS DRILLING INC <br /> Feet to Feet <br /> 70620 24 Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State <br /> Signed electronic signature received 07/27/2022 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <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 3 of 3 <br />
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