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Borehole Specifications Certification Statement <br />Depth from <br />Surface <br />Feet to Feet <br />Borehole Diameter (inches) <br />I, the undersigned, certify that this report is complete and accurate to the l>est of my itnowledge and t>elief <br />Name HENNINGS BROS DRILLING CO INC <br />Pet^on, 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 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 _2_of ^