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WP0043556
EnvironmentalHealth
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4300 - Water Well Program
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WP0043556
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Entry Properties
Last modified
9/14/2022 9:34:08 AM
Creation date
9/14/2022 9:29:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0043556
PE
4368
STREET_NUMBER
17423
Direction
S
STREET_NAME
ENTERPRISE
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
22926004
ENTERED_DATE
7/29/2022 12:00:00 AM
SITE_LOCATION
17423 S enterprise RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Borehole Specifications L' CertiiflcationlStatemeht <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 t>est of my Imowledge and lielief <br />Name 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 />Zip <br />Signed electronic signature received 09/01/2022 290813 <br />C-57 Licensed Water Weil Contractor Date Signed 0-57 License Number <br />) .'if, <br />-i"'' L' <br />CSG#State Well Number Site Code <br />! ' i'ti' • <br />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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