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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PINE
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2900 - Site Mitigation Program
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PR0516247
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Entry Properties
Last modified
6/23/2026 3:41:17 PM
Creation date
7/14/2021 9:05:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0516247
PE
2960 - RWQCB LEAD AGENCY CLEAN UP SITE
FACILITY_ID
FA0012531
FACILITY_NAME
CITY OF LODI-CENTRAL PLUME
STREET_NUMBER
221
Direction
W
STREET_NAME
PINE
STREET_TYPE
ST
City
LODI
Zip
95241
APN
04303111
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
221 W PINE ST LODI 95241
Tags
EHD - Public
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io �? SANAOAQUIN <br /> _ o.. <br /> Environmental Health Department <br /> —COUNTY— <br /> `,u Greatness grows here. <br /> u I Monitoring Well/Soil Boring Inspection Report <br /> Date: / v 1 Inspector: ��` A CONSTRUCTION <br /> Facility Address: 22t 1A1 <br /> Well Address: Q 21 W, 0. S Total Depth: <br /> WP# 00 91 v � Well#: 3 � Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: ; Screen Length From: To: <br /> Consultant: C41yi I ds Te Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWPLEfON COMMEnON <br /> Method: G=nd Swfact <br /> Screening Method: Grout <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> tt. <br /> tt. <br /> SPOILS . <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: sbrWd <br /> on <br /> Covered: ❑ Yes ❑No = g,,,w <br /> Pack <br /> If yes, material: b <br /> ✓ � : _= <br /> GROUTING or DESTRUCTION Total Depth: q _ <br /> Depth to Water: /'v- jn- n' <br /> Grout Material: 17 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: --0, (� Q G� <br /> Casing Type: <br /> ❑Well Installation 'Nell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout *ver Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ITremie (/ LJOther: Type of Method: <br /> Water Ceme 471b Water Cement 941b <br /> gall gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix 3%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 6 Q 1001 7 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />
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