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FIELD DOCUMENTS FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2725
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3500 - Local Oversight Program
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PR0544596
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FIELD DOCUMENTS FILE 1
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Last modified
6/24/2019 1:57:39 PM
Creation date
6/24/2019 11:36:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0544596
PE
3528
FACILITY_ID
FA0002064
FACILITY_NAME
7-ELEVEN INC. STORE #14117
STREET_NUMBER
2725
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2725 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REP6n'10 <br /> Date:/y 36/O CONSTRUCTION <br /> Premise Address: ZZ25 5 Total Depth 35 <br /> �^ Screen Length (from)__ 2.0 (to) 3 <br /> Well No.: _1-' Filter Pack (from)_3S (to) ! <br /> Bentonite (from) Iv (to) f(a <br /> Inspector: Grout (from) I& (to) O <br /> G Drilling rig type LT <br /> Permit No. ` ���1 G Auger O.D. I.D. <br /> Completion -Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: 4/ y` casing <br /> ?�,�, height , <br /> Consultant c'r <br /> Geologist ��,� •� <br /> ABOVE-GROUND *' Y-BOX <br /> COMPLETION C <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line L$p1 grout <br /> Domestic well on site - (y n , ft. <br /> If yes, location and distance - <br /> Z.y n ft. <br /> SAMPLING :lotted <br /> Holding Temperature /'U/� — _ vel pack <br /> Method _ <br /> Screening Method <br /> Tracking Sheet_ - (y/n) = s <br /> 1 5 ft. a; = ft- <br /> SPOILS <br /> Storage Method 55 pk,/ MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) ? Z ei S l Y <br /> Storage Location Oh Casing type 1 1/ <br /> Blank _20 ft. Screen <br /> Slot size (>Zo rt <br /> GROUTING Bags cement VO <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel q. <br /> Mix Ratios_ 3 (4" !( f LSC.. Vet A4)c Filter Pack type/size <br /> Installation Method_ Surge Block: - (y n) <br /> Quantity Installed !��j �� Discussed with geo st: - (y�Dn <br /> Type of method <br /> EH 29 29 <br />
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