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WP0040803
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040803
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Last modified
7/8/2020 1:03:51 PM
Creation date
6/25/2020 10:19:40 AM
Metadata
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Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040803
PE
4368
STREET_NUMBER
28728
Direction
E
STREET_NAME
LONE TREE
STREET_TYPE
RD
City
OAKDALE
Zip
95361-
APN
22912025
ENTERED_DATE
5/11/2020 12:00:00 AM
SITE_LOCATION
28728 E LONE TREE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Borehole Specificatolns Certification.Statement <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 06/23/2020 290813 <br /> C-57 Licensed Water Well Contractor Date Signed 6-57 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 /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/1912017 Page 2 of 2 <br />
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