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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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3011
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2900 - Site Mitigation Program
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PR0530063
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Last modified
2/6/2019 4:40:44 PM
Creation date
2/6/2019 3:41:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0530063
PE
2957
FACILITY_ID
FA0019769
FACILITY_NAME
FORMER SHELL GAS STATION
STREET_NUMBER
3011
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
10018010
CURRENT_STATUS
01
SITE_LOCATION
3011 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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WNg
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EHD - Public
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MONITORING WELL INSTALLATION REPOnf <br /> Date: CONSTRUCTION <br /> Premise Address: d1 ( , �(� �nt Total Depth <br /> �� Screen Length (from) (to) ?-C7 <br /> Well No.: Filter Pack (from) (to) Zf� <br /> Bentonite (from <br /> Inspector: (from)�(to) Z <br /> Q Q 7�Z C Drilling rig type S3 <br /> Permit No. Auger O.D. pipe/chLD <br /> ristie boxbox (c <br /> Drilling Company: Completion - Stove <br /> LIV <br /> Driller: casing <br /> //JJ / height <br /> Consultant /( <br /> Geologist_ �� U t� 6�t ^ ' <br /> ABOVE-GROUND <br /> CON9LETZN Ct6i15TY-BO <br /> CN <br /> SPECIAL PERMIT INFO. -I Ground Surfx <br /> Distance to sewer line grout <br /> Domestic well on site - (y n' <br /> If yes, location and distance - <br /> ft. <br /> = o <br /> SAMPLING <br /> Clotted c <br /> Holding Tempera tre = <br /> Method = g""w Pack <br /> Screening Method 7 <br /> Tracking Sheet <br /> tt. Ea I I tL <br /> SPOILSCale <br /> --� <br /> Storage Method O/ c- t (!!'' ,,mac ��S( — MATERIALS/DEVELOPM&NT l <br /> Contamination Noted - (y n <br /> Storage Location Casing type <br /> Blank ft. Screen l ft. <br /> Slot size Q Z-()r <br /> GROUTING Bags cement <br /> �/ r Buckets bentonite <br /> Depth to water [ ' Bags sand/gravel <br /> Mix Ratios — A z <br /> U Filter Pack type/size ; <br /> Installation Method --Ar)f Surge Block: - (y/ n) <br /> Quantity Installed — A/A Discussed with geologist: - (y/ n ) <br /> EH 29 29 11 <br /> X0 `� AtBc4_ �/ Type of method <br />
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