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FIELD DOCUMENTS_FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HARLAN
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15600
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3500 - Local Oversight Program
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PR0545273
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FIELD DOCUMENTS_FILE 1
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Last modified
2/3/2020 11:45:57 AM
Creation date
2/3/2020 11:00:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0545273
PE
3528
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
02
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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MONITORING WELL INSTALLATION REPT <br /> Date: C, I DS CONSTRUCTION <br /> Q I' Premise Address:!M 0 Total Depth 40 <br /> . �\\ Q Screen Length (from)_ o (to) <br /> Well No.: W O Filter Pack (from) (to) <br /> inn Bentonite (from) (to) <br /> Inspector: Y 'to L53( Grout (from (to) <br /> Drilling rig type h <br /> Permit No. Auger O.D. :�//a r r <br /> 1 � &tie b Completion - Stove pipe/ (circle one) <br /> Drilling Company: (o��c� <br /> Driller:. �AMX casing <br /> p height <br /> Consultant ©YC <br /> Geologist�ir� .. <br /> ABOVE-GROUND CHRIST 4= <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surtae* <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) 1 ft. <br /> if yes, location and distance - tt. <br /> m <br /> — o <br /> SAMPLING stottad _ 8 <br /> &*cion <br /> M*Icing Temperaturew = gravel pack <br /> ethodni <br /> �r <br /> Beng Method <br /> racking Sheet - (y/ n ) <br /> tt. tt. <br /> bILS <br /> rage Method MATERIALS/DEVELOPMENT <br /> tammation Noted - ( / n a r r A I (, <br /> !ge Location Casing type ' v <br /> Blank 2- _ft- Screen--15-ft. <br /> ft <br /> Slot size O T <br /> ITING Bags cement <br /> Buckets bentonite <br /> to water Bags sand/gravel <br /> trios Filter Pack typesize <br /> ion Method Surge Block: - (y/n ) <br /> Installed Discussed with geologist: - (y/n ) <br /> Type of method <br /> D <br />
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