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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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2908
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3500 - Local Oversight Program
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PR0544111
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Last modified
2/7/2019 11:18:32 AM
Creation date
2/7/2019 10:24:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544111
PE
3528
FACILITY_ID
FA0003625
FACILITY_NAME
ARCO STATION #83560*
STREET_NUMBER
2908
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09763032
CURRENT_STATUS
02
SITE_LOCATION
2908 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REPk,.oe <br /> Date: 4' 1 CONSTRUCTION <br /> Premise Address: V \1�a,-\O_ fru'o Total Depth TD <br /> Screen Length (from) i30 (to) <br /> Well No.: Filter Pack (from) 3a (to) /z <br /> Bentonite (from) L9%z (to) %Z <br /> Inspector: M L42 Grout (from) (to) <br /> Drilling rig type mcn(l (0 1 <br /> Permit No. Auger O.D. A3'5/4 I.D. 4 <br /> —�— Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: Ic�YI� /x ���� <br /> Driller: Kle U KA— "D ( casing <br /> � IT <br /> height <br /> Consultant J�AJv� G` e <br /> Geologist <br /> /ABOVE-GACUND CHRZTY48QX <br /> COMPLETION cOMPLETICN <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewerline grout <br /> Domestic well on site _ (Y <br /> n � 5� <br /> If yes, location and distanc - ..VWt+ �, r ft. <br /> of Lft. <br /> woad � cor�clos x:. _ � <br /> SAMPLING A'^" <br /> MW Z ttora.9 <br /> cwar"1 <br /> a�icn <br /> Holding Temperature = vd <br /> Method LU F <br /> Screening Method I P ' <br /> Tracking Sheet - n ) hftrt.rw Ima�_ <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n el Ap v G <br /> Storage Location IM Casing type Z_ <br /> Blank M ft. Screen 20 ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel Lo 1220.5 <br /> Mix Ratios Filter Pack type/size --03 — <br /> Installation Method Surge Block: - (y <br /> Quantity Installed Discussed with geologist: - (y A) <br /> Type of method <br /> EH 29 29 <br />
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