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WP0043047
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043047
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Entry Properties
Last modified
6/30/2022 11:51:49 AM
Creation date
5/25/2022 2:54:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043047
PE
4373
STREET_NUMBER
2165
Direction
N
STREET_NAME
UNION
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
20410056
ENTERED_DATE
3/4/2022 12:00:00 AM
SITE_LOCATION
2165 N UNION RD
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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IBorehoIei Specifications '^£;r;it^atibi^iStatem ''', <br />Depth from <br />Surface <br />Feet to Feet <br />Borehole Diameter (Inches) <br />l.thound <br />Name <br />is compiete and accurate to the best of my knowledge and belief <br />HENNINGS BROS DRILLING CO INC <br />Person, Firm or Corporation <br />1930 LADD RD <br />Address <br />MODESTO <br />city <br />CA <br />State <br />95356 <br />"ZiT" <br />Signed electronic signature received 05/18/2022 290813 <br />C-57 Licensed Water Well Contractor Date Signed 0-57 License Number <br />f'' I !f i- <br />CSG# <br />,0 :dWR U^eijphlyr r . <br />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 ^ of ^
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