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ARCHIVED REPORTS_XR0013114
EnvironmentalHealth
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FRONTAGE
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1022
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2900 - Site Mitigation Program
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PR0534875
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ARCHIVED REPORTS_XR0013114
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Entry Properties
Last modified
4/7/2020 2:13:34 PM
Creation date
4/7/2020 1:34:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0013114
RECORD_ID
PR0534875
PE
2960
FACILITY_ID
FA0020170
FACILITY_NAME
AAA TRUCK WASH/JIMCO TRUCK PLAZA
STREET_NUMBER
1022
Direction
E
STREET_NAME
FRONTAGE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
26102004
CURRENT_STATUS
01
SITE_LOCATION
1022 E FRONTAGE RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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'The free Adobe deader may be used to view and complete this corm. However,software must be purchased to complete,Sava,and reuse a saved farm. <br /> File Original With DWR s State of Callfomla PYR Use Ont.=°t]o Not Fill InV.', <br /> Page 1 i. of 1-- ' well Completion Report ' <br /> Refer(olnatycr7onPamahrel State wen NumberlSiteNumber <br /> Owner's Well Number UW—i2 No•04158118 N w <br /> Date Work Bogart Date Work Ended a Latitude Loncritude <br /> Loral Permit Age rrcy,S <br /> Permit Number. Permit ale J,u �2 AlOWTRSIOther . <br /> "G®oto ic.Lb WellOwlter:.. <br /> Orientation evertical 0Horizontal _OAnglo 5pedfy ' Name <br /> Drllllng Method Drilling Fluld s <br /> Mailing Address <br /> Depth from Surface ° : " Description g4n,1h <br /> ':Feet, ao '' t eat r Descrit a meteFlsl, 'relri size,color,et6 Ci State <br /> 71 <br /> t Address_JQ (•-,n.,�1" ,r~rs <br /> City - - �,- County an ,ynctciu:rl I <br /> Latitude. N Longitude <br /> 1 Den. Min, Sea' - 178G. Min. fief- ' <br /> DatumNnDB Decimal Laf: Declmal Long:- <br /> APN Book2-6. Page C.)-2 'Parcel <br /> Township 2S •Range_ - Section ' <br /> Loaafieh Sketch':: i4ctivl ; <br /> Sf elcn must Im drawn 1,y Whd sii"er form i.ymea.1 O New Well <br /> North0.ModificatiortfRepair- <br /> .0 Deepen <br /> i O Other <br /> Destroy <br /> WAC/ �Iannt a Uses='r = <br /> 0-Water SupplyAp <br /> ❑Domestic ❑Public <br /> 1., ❑Irrigation-❑Industrial <br /> LU <br /> O Cathodic Protedlun <br /> O Dewatering t <br /> O Heat Exchange <br /> O Injection <br /> t. O MoNtortng <br /> _ E�ady I is 333nnN'�F Nt�v�-19 0 Remedtatlon <br /> FcodSg br Y�r IS1 1,[\,N 0 Sparging <br /> South O Test Well <br /> iru�uM.m.reo'xaan�n�om,,.aream roaae.n,endroarenue: O Vapor Extraction'-- <br /> m®s,ate,�dettaclam9p•Wsnamaenm p�.rlf necvesey. 0 Other <br /> .. - .. Plow ha xeorM.and edn teM. <br /> _ Water Level:and.:Y-10d of:trsin Ieted.Well <br /> Depth to first water (Feet below surface) <br /> Depth Io.Static - <br /> Water Level (Feet) Date Measured <br /> Total Depth of Boring Feet EsUrnaled Yield• (GPM) Test Type <br /> Total Depth of'Completed Well Feet Test Length (Hours)Total Drawdown (Feet) <br /> May not be re resentalive of a well's long termyield- <br /> Material <br /> Depth from Borehole Type matailal' wall - Outside Screen Slot5tze Depth from <br /> Surface Dlameter yP Thickness Diameter M, Type If Any surface Fill Deaeripttort <br /> Fast lo Feet Incties ' - inches Inches) ftnch*sl Fest to Feet ' <br /> . t <br /> Attachments ,r -.•. Certif[catioii:Statenisnt <br /> ❑Geologic Log I,the undersigned,oerfify that this report Is complete and accurate to the best of my knowledge and belief <br /> ❑Well Construction Diagram Name Cascade Dri 1 l i ng: L-P- <br /> ❑Geophysical Lag(s) 3 Q2 Firm QMQ Circ1p, Eanclio Cordova CA X5742 <br /> ❑SolifWater Chemical Analyses VD <br /> cliy state ZIp <br /> ❑Other Signedd " 2./ � � . - - 08!14/12 935110 <br /> Aifach addllional inrmnelioa'Irif mcLvla. ---1111"7 ucensea water Well ConlraeterDate Signed C•57 License Number <br /> DWR 188 REV.(12006 IFADDITIONAL SPACE IS NFEDEn•USE 146XT CONSrClr WLY NUMBERED FOPM <br />
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