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WP0038340
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038340
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Entry Properties
Last modified
3/22/2019 2:16:15 PM
Creation date
10/25/2018 2:23:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038340
PE
4366
STREET_NUMBER
3701
Direction
W
STREET_NAME
LINNE
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
23920003
ENTERED_DATE
5/25/2018 12:00:00 AM
SITE_LOCATION
3701 W LINNE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
AMeuangkhoth
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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197 205 Sand Clayey <br /> 205 220 Sand W/Gravel <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specifications Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 200 Blank PVC OD:8.625 in.I SDR: 0.332 8.625 <br /> 26 1 Thickness:0.332 <br /> in. <br /> 1 200 220 Screen PVC OD:8.625 in.I SDR: 0.332 8.625 Saw 0.5 <br /> 26 1 Thickness:0.332 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 100 Bentonite Other Bentonite <br /> 100 220 Filter Pack Other Gravel Pack No.6 <br /> Other Observations: <br /> Borehole Specifications 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 /> 0 220 14 Person,Firm or Corporation <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 10/10/2018 290813 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <br /> PE <br /> State Well Number Site Code Local Well Number <br /> I I I I I N W <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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