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WP0041553
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041553
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Entry Properties
Last modified
12/27/2021 2:07:40 PM
Creation date
9/15/2021 1:33:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041553
PE
4370
STREET_NUMBER
2555
Direction
N
STREET_NAME
BEYER
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
10102209
ENTERED_DATE
12/24/2020 12:00:00 AM
SITE_LOCATION
2555 N BEYER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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230 <br />240 <br />CLAY <br />240 <br />243 <br />SAND <br />243 <br />256 <br />CLAY <br />256 <br />266 <br />SAND <br />266 j <br />282 <br />CLAY <br />282 <br />285 <br />SAND <br />285 <br />287 <br />CLAY <br />287 <br />290 <br />SAND <br />290 <br />294 <br />CLAY <br />294 <br />297 <br />SAND <br />297 1 <br />310 <br />CLAY <br />Other Observations: <br />Borehole Specifications <br />Casings <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Casing <br />Depth from Surface <br />Casing Type <br />Feet to Feet <br />Material <br />Casings Specificatons <br />Wall <br />Thickness <br />Outside <br />Diameter <br />Screen <br />Slot Size <br />if any <br />Description <br /># <br />Feet to Feet <br />Address City State Zip <br />Signed electronic signature received 07/20/2021 668622 <br />(inches) <br />(inches) <br />Type <br />(inches) <br />CSG # State Well Number Site Code <br />1 <br />0 <br />280 <br />Blank <br />N W <br />PVC <br />OD: 6.900 in. i SDR: <br />0.329 <br />6.9 <br />APN: <br />21 i Thickness: 0.329 <br />in. <br />2 <br />280 <br />300 <br />Screen <br />PVC <br />OD: 6.900 in. i SDR: <br />0.329 <br />6.9 <br />Saw <br />0.045 <br />21 i Thickness: 0.329 <br />Cut <br />in. <br />Annular Material <br />Depth from <br />Surface <br />Fill <br />Fill Type Details <br />Filter Pack <br />Size <br />Description <br />Feet to Feet <br />0 <br />100 <br />Bentonite <br />High Solids <br />100 <br />1 300 <br />Other Fill <br />See description. <br />GRIT SAND <br />Other Observations: <br />Borehole Specifications <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Surface <br />Borehole Diameter (inches) <br />Name MASELLIS DRILLING INC <br />Feet to Feet <br />Person, Firm or Corporation <br />0 1 310 <br />11 <br />119 ALBERS ROAD MODESTO CA 95357 <br />Address City State Zip <br />Signed electronic signature received 07/20/2021 668622 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />DWR Use Only <br />Attachments <br />Image_02664.pdf - Permit <br />CSG # State Well Number Site Code <br />Local Well Number <br />N W <br />Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br />TRS: <br />APN: <br />Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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