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Borehole Specifications Certification Statement <br /> Depth from Borehole Diameter I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and <br /> Surface belief. <br /> (Feet to Feet) (inches) <br /> MASELLIS DRILLING INC <br /> Name: <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO California 95357 <br /> Address City State Zip <br /> electronic signature received 10/21/2025 668622 <br /> Signed: <br /> C-57 Licensed Water Well Contractor Date Signed 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 /> APN: - <br /> Township: Range: _ <br /> Section: Tract: _ <br /> SEQ: BM: _ <br /> MIS` J a: <br /> r� <br /> No Attachments <br /> DWR Form 188 rev 10/09/2025 Page 2 of 2 <br />