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WP0042998
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CARROLTON
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042998
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Entry Properties
Last modified
4/1/2022 12:28:00 PM
Creation date
3/30/2022 8:50:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042998
PE
4373
STREET_NUMBER
21399
Direction
S
STREET_NAME
CARROLTON
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
24522002
ENTERED_DATE
2/23/2022 12:00:00 AM
SITE_LOCATION
21399 S CARROLTON RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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Tags
EHD - Public
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Boreho a iecifications ; � �iW "` <br /> IcatlonState <br /> -1,?rent <br /> i.r� 7g:� ..,..er'.aiyR�ii •��t <br /> 3-., t; ;,»:, . ._ tri•: E 1. <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 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 03/24/2022 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> L + r t s F s <br /> DWR�UseO�l ►, x�� '° <br /> �tf{ ,r�h!S�»��s�.�:k? <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 2 of 2 <br />
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