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FIELD DOCUMENTS_FILE 2
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HAMMER
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3555
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3500 - Local Oversight Program
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PR0545252
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FIELD DOCUMENTS_FILE 2
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Last modified
1/31/2020 12:09:16 PM
Creation date
1/31/2020 10:51:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0545252
PE
3528
FACILITY_ID
FA0002232
FACILITY_NAME
QUIK STOP MARKET #3132*
STREET_NUMBER
3555
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
071-180-20
CURRENT_STATUS
02
SITE_LOCATION
3555 W HAMMER LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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i <br /> +. 'The free Adobe Reader may be used to New eI wmple(a'his form. However,software must he purchased to complete.savy'$d reuse a saved font. <br /> , <br /> - <br /> I' State of California +.' s:. 9» Fill'In <br /> g, File Original with DWR well Completion Report <br /> Page �� of � `Rekrro mstrudion Pamphlet - State Well NumberlSite Numb <br /> t Owner's well Number MW-11R - 1i.NO. e0156691 N W <br /> Date Work Began 07/10/2012 Dale Work Ended X7/10/ m Latitude Lon nude <br /> -_ ,___..:_County Environmentol I-traalth <br /> Local Permit Agency �' APNRRS/Other <br /> Permit Number 0065150 — Permit Date 6/11/12 <br /> or entation OVertieal 0 Horizontal OAngle Specify Name ATC Associates <br /> Drilling Method A er Drilling Fluid Mailing Address 6602 Owens Drive#100 <br /> ` ribs' °� t Ci Pleasanton State CA 94588 <br /> Overdrill to abandon 2-32-well It <br /> p;. Address 3555 West Hammer ne <br /> City Stockton CO, San Joaquin <br /> IAelly Latitude4i itud _ v <br /> IpIt seatIt- , Dep. Min Sec X,79K'§G Mia ec <br /> } Datum Djecirm Decimal Long. .,;dr <br /> APN Book `.V''P��aarcel 'w- <br /> TovmShip A aarf-8a�_ $ on <br /> s a w as O N$W Well _ <br /> .orth Mo ification/Repair <br /> �� sx O Deepen <br /> .; O Other <br /> a • Destroy <br /> DeI,I phtsadures and materials <br /> Ir ` uMa GEOLOGIC LOO' <br /> O Water Supply <br /> -C;5 []Domestic ❑Public <br /> Iy .tom w ❑Irrigation ❑Industrial <br /> O Cathodic Protection <br /> >111 ,g _ O Dewatering <br /> O Heat Exchange <br /> r r !I ,?,` ?�-•' O Injection <br /> num0 Monitoring <br /> N&, O Remediation <br /> ° O Sparging <br /> '0 South O Test Well <br /> .mO Vapor Extraction <br /> wadss.reDnaIrr,:.enO Other <br /> •r �" weueax.,,,amand. mm. <br /> +, <br /> _-e '03TRUP1 <br /> De tit to first water <br /> p (Feet below surface) <br /> Depth to Static <br /> Water Level (Feet) Date Measured <br /> Total Depth of Ming .,FF.eel Estimated Yield• (GPM) Test Type <br /> ;r Test Length (Hours) Total Drawdown (Feet) <br /> Total Depth ompleted Well w+,. :rn Feet ) <br /> v. 1*May not be re resentative of a well's long term yield. <br /> , as�fi <br /> . kn1:%: 1tna."_'alb, . 10a <br /> 1 Deurface "$D hole w ype "`rise Material wall Outside .Screen Slot Size Depth from <br /> 1 0. Thickness Diameter Type if Any Surface Fill Description <br /> Feet to Fast Inch v"' Inches Inches Inches Fast to Feel <br /> I <br /> r <br /> .o4°xfa wt, L- <br /> 1. q e <br /> l_ <br /> ❑Geologic Log 1,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> ❑Well Construction Diagram Name Cslscade Drilli__a.L.P. <br /> ❑Geophysical Log(s) Person,Flim or corporation _ <br /> 632 Onnec Circle Rancho Cordova CA 95742 <br /> ❑ Soil/Water Chemical Analyses Add city State zip <br /> O Other: Mai) Signed �� la TQ_ ,�'�p 07/17/2012 938110 <br /> AaecnaddHionm inrwmetion an extra. o57 llcameaWeter vdencontrau« Date signed C-57 License Number <br /> DAR 188 REV.in" IF ADDITIONAL SPACE IS NEEDED,USE NEXT CONSECUTIVELY NUMBERED FORM <br /> in <br /> i. <br /> It <br /> r <br />
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