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SR0085711_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0085711_SSNL
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Last modified
9/19/2022 12:15:58 PM
Creation date
9/19/2022 12:08:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0085711
PE
2602
STREET_NUMBER
1410
Direction
W
STREET_NAME
FREWERT
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19127021
ENTERED_DATE
8/29/2022 12:00:00 AM
SITE_LOCATION
1410 W FREWERT RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Borehole Specifications <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my Imowledge and belief <br />Surface <br />Feet to Feet <br />Borehole Diameter (Inches) <br />Name MAGGIORA BROS DRILLING INC <br />Person, Firm or Corporation <br />595 AIRPORT BLVD WATSONVILLE CA 95076 <br />Address City State Zlp <br />Signed electronic signature received 10/13/2020 249957 <br />C-57 Licensed Water Well Contractor Date Signed C-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. 12/19/2017 Page Z of Z <br />
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