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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HUTCHINS
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305
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3500 - Local Oversight Program
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PR0545307
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Last modified
2/11/2020 10:23:37 PM
Creation date
2/11/2020 8:52:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545307
PE
3528
FACILITY_ID
FA0000932
FACILITY_NAME
DOMINO'S #8588
STREET_NUMBER
305
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
03319020
CURRENT_STATUS
02
SITE_LOCATION
305 S HUTCHINS ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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IowroRING WELL INSTALLATION REP <br /> Date% t j CONSTRUCTION <br /> Premise Addressc !t '19/.� Total Depth <br /> Screen Length (from) , ; w(to)-z-6 <br /> Well No.. -~ Filter Pack (from) (to <br /> Bentonite (from)� <br /> Inspector: <br /> Grout Mom <br /> Drilling rig type <br /> Permit No., Auger O.D. , I.D. <br /> ComptetIbA Stove pipcicl ristie box (circle one) <br /> Drilling Company: <br /> casin `x <br /> YceighC: <br /> Geologist «, <br /> A OVE-GROUNO, <br /> COMPLETION COMPLETION <br /> SPECT PERW—T IN—P-0., C d'Suriaca <br /> grct <br /> Dist to.so.ver Ime <br /> ,. <br /> Dome tic t+rielt.:.+an.site:•:(.y.:.': :: ftti <br /> If yes, lbeitit►n and distance <br /> X <br /> 40 <br /> >� a <br /> SAMPLING xlorad <br /> seticn <br /> Holding Ternperature <br /> : av01 Pack <br /> Method <br /> Screening Method. <br /> .f, ... .. <br /> Tracking Sheet ,.- l tx <br /> . tfv <br /> Storage Method MATERI& jDEVEI OP�+II N'I` <br /> Contamination Notedy I ) rl <br /> Storage Location `- ems,a-� - Casinga <br /> Blank o ft. Screen - _ Z-3 ft. <br /> Slot;size -U :0 <br /> GROONG Bags cement <br /> Buckets bentonite <br /> Depth to Nvater-ak1 r Bags sand/gravel -- <br /> Mix patios Filter Pack typelsiz <br /> Installation.Methods Surge Block. - (y i ) <br /> Quantity installed f r_______ Discussed with geoogist - n <br /> Type of method.:. <br /> EH 29 2 <br />
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