Laserfiche WebLink
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 /> MASELIIS DRILLING INC <br /> Name: <br /> Person,Firm or Corporation <br /> 119 ALBERS ROAD MODESTO California 95357 <br /> Address City State Zip <br /> Signed: electronic signature received 12/03/2025 668622 <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 /> No Attachments <br /> DWR Form 188 rev 10/09/2025 Page 2 of 2 <br />