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ARCHIVED REPORTS XR0012550
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LODI
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851
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3500 - Local Oversight Program
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PR0544084
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ARCHIVED REPORTS XR0012550
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Entry Properties
Last modified
2/1/2019 4:45:32 AM
Creation date
1/31/2019 4:31:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012550
RECORD_ID
PR0544084
PE
3500
FACILITY_ID
FA0005447
FACILITY_NAME
LODI READY MIX & BLDG MATERIAL
STREET_NUMBER
851
Direction
E
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
851 E LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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TMorelli
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EHD - Public
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v <br /> / CX N 113 IT r " <br /> STATe OF CALIFORNIA S <br /> I'RIPLICATE TNt:RESOURCES AGENCY <br /> Owner's Copy DEPARTMENT OF WATER RESOURCES DO not ft1J 7r7 <br /> WATER WELL DRILLERS REPORT N0, 256439 <br /> `•e of Intent Na <br /> State Well No. <br /> Local Permit No.or Date . Other Well No <br /> (1) OWNER: Name r,I Il V Of T,odf (12) WELL LOC, Total depth ft.Completed depth it, <br /> ddrass�� 1 E`{@St �j Y19 s1T(3e <br /> Cat <br /> from ft. to ft. Formation(Describe by color,character•size or merial) <br /> City A j 8 ZfP <br /> (2) LOCATION OF WELL(See instructions): 13 <br /> - <br /> Courty Owners Well Number - 4(1 Rnnd <br /> - <br /> Well address if different from above 10 5. E Lodi Avenue <br /> Township._ Range Section - <br /> Distance from cities,roads,railroads,Fences,eta - <br /> (3)TYPE OF WORK; <br /> New Well 13 Deepening ❑ <br /> Reconstruction ❑ <br /> Reconditioning 08 <br /> Horizontal Well �] - <br /> truction C] <br /> des ru tion mater <br /> ab nand pro- <br /> 1 cedures in Item 12) <br /> (4) PROPOSED IJ �- - <br /> 1 Domestic _ <br /> Irrigation <br /> Industrial <br /> Test Well O ❑ Cp - 06 d <br /> municif ❑ - 4 la <br /> Wer Sand <br /> be) V ` - <br /> WELL LOCATION sx�Tcca <br /> ff 2 - 2 ---.Pandy Herd Pan w streaks: <br /> 5) EQUIPMENT. CRA GK May <br /> .a4 Rotr::.r Rcrctse No _59-5Sandy Hard Pan <br /> ` <br /> Cable - Alt ❑ et of 111 - 00 Sand Hard Pan & Clay <br /> Ether ❑ Buck s ed from <br /> 1 <br /> -- ;' (7)CAStNG1N5`TALLED. - <br /> fi <br /> f Steel IX.a: Pru - <br /> tic ❑ e ❑ Ty rf ion or rite <br /> P _ <br /> 1 Fr0171 0 1] Ca @ OP Ot <br /> Ft r [r� Wali size _ <br /> 310 -395 $td <br /> .(9) WELL SEAL: n _ <br /> 4Vusurla�v sanitary snl provlded7 Y.M No❑ lit ax to depth_ft. _ <br /> Were sesta sealed aga!art pollutions' Yes❑ No❑ Interval it _ - - <br /> Mrthvd of swling Work started 19 Completed--- <br /> (10) WATER LEVELS: WELL DRILLER'S STATEMENT: <br /> Depth of firm Wncr,if known <br /> - -- --- r-- --- ---- - -- - - <br /> -- ft -- - --- - - - -- - - <br /> {- <br /> Standing 6ve1afterWtllcnmpletion [t. This well ince drifk tindtr.-ittll�msrdsdlcllors and this report is true to!!re - <br /> brei of my knoAAI 19Fftej/J } <br /> _,�.f ll) WELL TES'T'S: Signed� 1� J 4 <br /> Ls well test modes Yes CX No❑ tF yes,by whom?— •` , — - <br /> rm or co rttmisr)- <br /> Pump❑ &Iles Air Elft ❑ ( air <br /> NAME Clark well & u "tient o. Inc, <br /> t. <br /> to Weleral cart of Iwt - rt. - At end of tnt f, f Ptrsom II . . . <br /> f. DfscharCt.��Gal/minsfler hours Wateritm stun, Address 20 F:sstE7t (Tytv:dorprinted! <br /> pa _Ch:a�ar Wsay <br /> Chemlcilanalysitmadrp.Ycs❑ No C) Ilya by whom? City_ S" OC1f CDs]. f!sY l i frons ZIP' <br /> ..Waselearielogm&do Ym <br /> OC No© IF nauaeh toil lest LicauseNo Date of this re rt_ <br /> 01TR 100 4111tV.loam .IR ASorril NAL SPACE 14 NEEDED, USE NEXT CONSCCtlrlVELY NUMBER <br /> COFORM <br /> - 4 9673] <br /> RECEIVED SLP 1 1990 - <br />
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