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WP0038819
EnvironmentalHealth
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ALPINE
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11707
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038819
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Entry Properties
Last modified
8/1/2019 1:49:09 PM
Creation date
11/28/2018 9:51:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038819
PE
4378
STREET_NUMBER
11707
Direction
N
STREET_NAME
ALPINE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
06116031
ENTERED_DATE
9/28/2018 12:00:00 AM
SITE_LOCATION
11707 N ALPINE RD
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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98 117 Clay <br /> 117 122 Sand <br /> 122 132 Clay <br /> 132 135 Sand <br /> 135 152 Clay <br /> 152 185 Sand <br /> 185 210 Clay <br /> 210 229 Sand <br /> 229 265 Clay <br /> 265 280 Sand <br /> 280 285 Clay <br /> 285 295 Sand <br /> 295 300 Clay <br /> Casings <br /> Wall Outside Slot Size <br /> Casing Depth from Surface Screen <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 260 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 1 260 300 Screen PVC OD:8.625 in. I SDR: 0.41 8.625 Saw 0.05 <br /> 21 1 Thickness:0.410 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 200 Bentonite Other Bentonite <br /> 200 1 300 Filter Pack Other Gravel Pack <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 /> 300 14 Person,Firm or Corporation <br /> 0 <br /> 1930 LADD RD MODESTO CA 95356 <br /> Address City State Zip <br /> Signed electronic signature received 11/15/2018 290813 <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 Tw <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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