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WP0039901
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039901
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Entry Properties
Last modified
12/15/2020 2:26:17 PM
Creation date
12/15/2020 2:23:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039901
PE
4366
STREET_NUMBER
9263
Direction
E
STREET_NAME
SCHMIEDT
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05111067
ENTERED_DATE
8/1/2019 12:00:00 AM
SITE_LOCATION
9263 E SCHMIEDT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\fgarciaruiz
Tags
EHD - Public
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Site Address: 9263 E. Schmiedt Rd. Lodi, CA 95240 Record ID: WP0039901 - <br /> Date: 08/08/2019 <br /> PHOTO#2 Well Construction Inspection. And Soil Log Comments: Observed Well Grouting With Cement <br /> nylons ALSTW <br /> " OM A►`+ . - <br /> �SS LICE- S DOARD AND 7T 1 <br /> cite r -� pd, I r SE <br /> _ Con 69 <br /> T One �ONTRTORS STA NS , P( EASE CALL (209) 953-7 <br /> G>r5. GA�IFORNIA ED FOR <br /> INSPECTIO DATE <br /> 6Rp NIN THE <br /> ws UIR <br /> vNT q CNAGTIVE OUR AIOVANCE NOTICE REO <br /> CJRRE pENSATION TITLES—� <br /> y;ERS CGM 1 0 <br /> MINIMUM 48 N 1 <br /> r 1 <br /> �. <br /> R.� t <br /> \ at t <br /> 1 t \ t 1 <br /> _l <br /> DEPARTMENT USE ONLY <br /> Appiication Accepted By Date <br /> Grout Inspection By --------- Area <br /> Date <br /> Pump Inspection By — r SPECIAL W <br /> Soil Boring Inspection By Date <br /> COMMENTSDale WAIVER Rec <br /> _ <br /> --.___ -- Constructed Well Depth <br /> PE <br /> Codes SC Received '----- ------ —�_� <br /> Info B Check#/ Am- aunt <br /> Cash ' <br /> -------_ <br /> Remitted Date Permit/ s <br /> ---_____ --- Service Re <br /> quest # Invoic <br /> Aaron Gooderham, Environmental Health Asst. Page 2 of 2 <br />
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