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FIELD DOCUMENTS FILE 2
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544513
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FIELD DOCUMENTS FILE 2
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Last modified
5/31/2019 5:11:02 PM
Creation date
5/31/2019 4:46:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0544513
PE
3528
FACILITY_ID
FA0024115
FACILITY_NAME
WEST CLAY PROPERTY
STREET_NUMBER
639
Direction
W
STREET_NAME
CLAY
STREET_TYPE
ST
City
STOCKTON
Zip
95209
APN
14707110
CURRENT_STATUS
02
SITE_LOCATION
639 W CLAY ST
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
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EHD - Public
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MONITORING WELL INSTALLATION REF�iT <br /> CONSTRUCTION <br /> Date: <br /> vCLTotal Depth <br /> ?remise Address: Screen Length (& m) D (to) <br /> Well No.: I , / G 1 /U F Iter Pack (tom) (to) <br /> Bentonite (from) __�l Grout (from) (to) — <br /> inspector. Dreg rig type <br /> Auger O.D. I <br /> Permit No. Completion - Stove pip tie box (circle one) <br /> Drilling Company: <br /> casizq <br /> Driller. _ . ` — heigh� <br /> Consultant <br /> `� � n <br /> Geologist 'A ABCV=--GRC UNO <br /> C�FItS^!-oCX <br /> OCN =-I IICN C--AIPL-TCN <br /> Ground Sufra <br /> SPECIAL PERMIT INFO. <br /> e grcctL <br /> Distance to sewer line <br /> Domestic well on site - ( y <br /> rf yes, location and distance - <br /> S Cry - 3 <br /> e <br /> go ted <br /> SAMPLING O _ 36 wccn = <br /> tore I S R <br /> oldir Tempera �" Pack <br /> 15 B �5 ,� _` <br /> Mehod { <br /> Screening Method = <br /> Tracking Sheet ( Y/ n ) <br /> tc. <br /> SPOILS <br /> MATERIALS/DEVELOP'.�NT <br /> Storage Method <br /> Contamination Noted - (y/ n ) Casing type --- <br /> Storage Location Blank ft. Screen <br /> Slot size <br /> Bags cemen <br /> ROUTING Buckets <br /> Buckets bentonite <br /> Bags sand/gravel <br /> pth to water Filter Pack type/size <br /> Ratios Surge Block: - / n ) <br /> 'allation Method Discussed with geologist; - C y/ n ) <br /> miry Installed Type of method <br /> 9 29 <br /> L:L...a <br /> _./' <br />
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