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WP0044145
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044145
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Entry Properties
Last modified
8/8/2024 4:07:39 PM
Creation date
6/3/2024 11:46:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044145
PE
4369
STREET_NUMBER
4343
Direction
E
STREET_NAME
MORTENSEN
STREET_TYPE
RD
City
MANTECA
Zip
95337-
APN
24120004
ENTERED_DATE
12/13/2022 12:00:00 AM
SITE_LOCATION
4343 E MORTENSEN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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222 226 sand <br /> 226 232 blue clay <br /> 232 260 sand <br /> 1� <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings SpeCNicatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> 1 0 75 Conductor or Mild Steel N/A 0.025 30 conductor casing <br /> Fill Pipe <br /> 2 0 140 Blank Mild Steel Nominal Size: 16 In.1 0.25 16 <br /> Thickness:1/4 in. <br /> OD: 16 in. <br /> 2 140 170 Screen Mild Steel Nominal Size:16 in. 0.25 16 Louver 0.09 FUL-FLO Perforations <br /> Thickness:1/4 in. <br /> OD: 16 in. <br /> 2 170 200 Screen Mild Steel Nominal Size:16 in. 0.25 16 Louver 0.09 Less Perforations <br /> Thickness:1/4 in. <br /> OD:16 in. <br /> 2 200 260 Screen Mild Steel Nominal Size:16 in. 0.25 16 Bridge 0.09 FUL FLO perforations <br /> Thickness:1/4 in. Slot <br /> OD: 16 in. <br /> Anrt�(aN[aterial <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 75 Cement 10.3 Sack Mix <br /> 0 1 260 1 Filter Pack Other Gravel Pack No 6 sand pack <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> ..-, .,..... ..t.tx. <br /> Depth from 4 the undersigned,oertHy that Oils report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name HENNINGS BROS DRILLING CO INC <br /> Feet to Feet <br /> Person,Firm or Corporation <br /> 0 75 36 <br /> 75 260 26 1930 LADD RD MODESTO CA 95356 <br /> Address City State <br /> Signed electronic signature received 08/08/2024 290813 <br /> C-57 Licensed Water Well Contractor /Date Signed C57 License Number <br /> DRUSec''O� • ,. <br /> P$ <br /> CSG# State Well Number Site Code Local Well Number <br /> N FTi I i I i 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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