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Boreh`ale Speciflcations x Stat ' ant <br /> rtC' <br /> .. ..-'� ,:..:.c.A,.+,.a. •, x:'...�.sr <.. �.._�:;.-.4^d:x�.:Kxh+-. .�, �.�Hau�-r .r ,�,ua�ri �h�4�°A'�. I���I �II��iQ�i!ft�7..e':ec."La`,•a;k,,:�",��„1� ��i���i.Ptdw�"'s i,,�,i <br /> Depth from I,the undersigned,certify hat this report is complete and accurate to the best of my knowledge and baler <br /> Surface Borehole Diameter(inches) Name HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> 0 50 28 Person,Firm or Corporation <br /> 50 480 22 1930 LADD RD MODESTO CA 95356 <br /> 480 500 8 Address City StateZip <br /> Signed electronic signature received 05/08/2024 290813 <br /> C-57 Licensed Water Well Contractorp Date Signed C.57yUcense Number <br /> ksf�.',a`"t-. .i- <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 3 of 3 <br />