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WP0042874
EnvironmentalHealth
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4300 - Water Well Program
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WP0042874
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Entry Properties
Last modified
9/16/2022 11:32:56 AM
Creation date
9/16/2022 11:27:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042874
PE
4366
STREET_NUMBER
27851
Direction
S
STREET_NAME
LAMMERS
STREET_TYPE
RD
City
TRACY
Zip
95377-
APN
20924010
ENTERED_DATE
12/30/2021 12:00:00 AM
SITE_LOCATION
27851 S LAMMERS RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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B Md i 61 <br />Depth from <br />Surface Borehole Diameter (inches) <br />Feet to Feet <br />0 1 400 13 <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Name CANEPA AND SONS INC <br />Person, Firm or Corporation <br />14384 CUESTA COURT SONORA CA 95370 <br />Address City State <br />Signed electronic signature received 09/13/2022 425749 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />CSG # 1 State Well Number I Site Code 1 Local Well Number <br />MMMn MMMMMI <br />Latitude Deg/Min/Sec <br />TRS: <br />APN: <br />Longitude Deg/Min/Sec <br />Form DWR 188 rev. 12/19/2017 Page 3 of 3 <br />
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