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WP0039561
EnvironmentalHealth
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DUNCAN
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1540
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039561
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Entry Properties
Last modified
2/13/2024 11:15:30 AM
Creation date
9/19/2019 4:38:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039561
PE
4369
STREET_NUMBER
1540
Direction
N
STREET_NAME
DUNCAN
STREET_TYPE
RD
City
LINDEN
Zip
95236-
APN
10514013
ENTERED_DATE
4/29/2019 12:00:00 AM
SITE_LOCATION
1540 N DUNCAN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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243 246 SAND <br /> 246 276 CLAY <br /> 276 298 BLACK SAND <br /> 298 333 SHALE <br /> 333 335 BLACK SAND <br /> 335 345 CLAY <br /> 345 346 BLACK SAND <br /> 346 400 CLAY <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Tif any Description <br /> Type(inches) (inches) (inches) <br /> 1 0 270 Blank PVC OD:8.625 in. I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 2 270 350 Screen PVC OD:8.625 in. I SDR: 0.41 8.625 Saw 0.045 <br /> 21 1 Thickness:0.410 Cut <br /> in. <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 60 Bentonite High Solids <br /> 60 1 350 Other Fill See description. BIRDSEYE <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name MASELLIS DRILLING INC <br /> Feet to Feet <br /> .---77400 14 <br /> Person, Firm or Corporation <br /> 119 ALBERS ROAD MODESTO CA 95357 <br /> Address City State Zip <br /> Signed electronic signature received 08/02/2019 668622 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> Attachments DWR Use Only <br /> Moorman's 1540 n duncan-Map.pdf-Location MapP�i <br /> State Well Number Site Code Local Well Number <br /> Image_00135.pdf-Permit <br /> :N: Ew <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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