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HomeMy WebLinkAbout021-132-056 EHWS24-0061 WELL LOG, DESTRUCT (2)Borehole Specifications Certification Statement Depth from I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief Surface Borehole Diameter (inches) Name W.S. HEITMAN DRILLING & PUMPS Feet to Feet Person, Firm or Corporation 623 BUCKINGHAM PLACE CHICO CA 95973 Address City State Zip Signed electronic signature received 01/10/2025 386577 C-57 Licensed Water Well Contractor Date Signed C-57 License Number DWR Use Only CSG # State Well Number Site Code Local Well Number N LW Latitude Deg/Min/Sec Longitude Deg/Min/Sec TRS: APN: Form DWR 188 rev. 12/19/2017 Page 2 of 2