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FIELD DOCUMENTS_FILE 2
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 2
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Last modified
2/3/2020 11:58:01 AM
Creation date
2/3/2020 11:00:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
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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EHD - Public
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'The rine Adobe Reeder may be aced Io vlaa and��ne Nb Tenn. Hmvnaer,6arbLmm mann be pumllaeea m mmptere.�^ end reuse n faVed term. <br /> File Original with DWR State of California DwR Use only—De Net Fal In <br /> Well Completion Report <br /> Page 1 of 1 5MM lrrNl Numere-a-3-l-te-N-a-m�mn � <br /> Owners Well Number MW-2 No. e0107saa <br /> .Date Work Began 02/10/7.010 Da to Work Bided 7H 9 10 l.ealluda Ile+ a <br /> Local Porm l Agency !__ _" . n1v Fnvirnnmentai Health Dgot I I ARNrrRsrom <br /> Permlt NumbariR,52aa2 -. Permit bate-2112/10 <br /> c �+94. <br /> . . • •.Gaoto ICL r.: 1. Well Owner <br /> Onto on OVertioal O Horizontal OAngle Speciry Nanhp Da(wlnder Dhool <br /> Diem;MA ad Dnlling Fluitl Meiling Address 155rm Sotdh Harkin Road <br /> 1 Depth from Surfaort� '.. ... .. Do"cAPti?^' C Is+thlroo State CA 95330 <br /> 9 Poet w FIMI'' 'DancrlbomPt(+rl°I in afu edpr lac <br /> . Well Location <br /> Pressure grout with neat cement Addreas <br /> Remove vault box city <br /> I?t11r00 _OOul11y Slon JoeaWn <br /> Remove upper 3 feet of well materials I-ttltudeN Longitude <br /> Patch round surface Dm rain. Sa. oxo. <br /> . <br /> Datum Decimal Lad. Dedmal Long. <br /> APN Books._— Page 200.... Parcel 79 <br /> Towns —Range Section <br /> Location Sketch Activity <br />{ .n.lseimamxn nnMsmr I. amw. 7UNewVVafl <br />{ NWP O O e Deepen <br /> i O Ogren <br /> ,V ) O Destroy <br /> S -"�. ne�e�lnnrmm mm�mnenan <br /> g� aevrol.unmloP <br /> fAkr2 Planned Uses <br /> O Waren supply <br /> ❑Donresgc ❑PWlic <br /> i t w ❑Irtgallon ❑Industrial <br /> 1 �o ' O Cathodic Protedian <br /> O nearawrill <br /> — 151r0U O Haat Exchange <br /> 1 O mledion <br /> �-- -- O Monitoring <br /> O Remadlailm <br /> O Sparging <br /> oath O Test Wal <br /> mar a mmrm.enaneeMveeneanwabwama ek... O Vapor Extraction <br /> amr,xe.ea.rcanemnP.uneeabealayerrmaa.rv, OOther <br /> Nvwb..eeunneMe IeU <br /> Water Level hnd,Yleld of Completed Well <br /> i Depth to get water (Feet below surface) <br /> _ Depth to Sialic <br /> . Water Levo) (Feet) Date Measured <br /> Total Depth of Boring Feet Estimated Yield (GPM) Test Type <br /> Total Depth of Completed Wan 19.5 Feet Tact Length (Hours) Total Drowdoym______(Feel) <br /> 'M no16e esendathre of a well's lona tum ak- <br /> .. . . Casln : • . . . Annular Material <br /> noplh room Borobah, MH Oubida screen Slat She Depth from <br /> surmee Dlemate ° Matmlat Thieknene tllamninr Type if Any anrrncn Fin Description <br /> Fvct N Feat flinchad Inches nchoe brohae Feet to Feet <br /> i <br /> Attachments •Certlfication Statement <br /> ©Geologir,Log I,the undersigned,canffy teat lhla report ie Complete and accurate to the best of my k nerMadge and eater <br /> ©Wen Construction Diagram Nerve RSI 61lino I'.OntD�V <br /> Pa9M,omit m CmPATIbn <br /> O Geophysical Logs) N rt R291 Akget Woodland Safi 95770 <br /> ❑sonn"ter OnemlCal AnalysesP - CV b80 ap <br /> El Other Site Plan - 5gned l ui0 ()02334 <br /> A cal�IrnnnnaMMerwolqmronr Date Signed 0.57 License Number <br /> CWR Ido REV,10.208 IF AMITIORAI SPACE IF WFMO,IIEE NS%T DONSar]rrrVMY NUMBERED FORM <br /> i <br />
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