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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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10848
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2900 - Site Mitigation Program
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PR0536777
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Last modified
6/18/2019 11:24:32 AM
Creation date
6/18/2019 11:08:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0536777
PE
2960
FACILITY_ID
FA0021126
FACILITY_NAME
FORMER COUNTRYSIDE MARKET
STREET_NUMBER
10848
STREET_NAME
COPPEROPOLIS
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10311006
CURRENT_STATUS
01
SITE_LOCATION
10848 COPPEROPOLIS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REPORT <br /> Date: G I CONSTRUCTION <br /> Premise Address:_ 1pe%6 z16PARqb4S Total Depth DO <br /> Well No.: /} S Screen Length (from) f/U (to) <br /> Filter Pack (from) 0 (to) <br /> Bnt <br /> J rpv� Bentonite (from) �G-7 (to) <br /> N <br /> Inspector: Grout (from) 0 (to) i <br /> SQ�o.�6q8 3 Drilling rig type' m <br /> Permit No. Auger O.D. 13' I.D. 4 <br /> Drilling Company:_ C�S CG(I Q Completion - Stove pipe/christie box (circle one) <br /> . <br /> Driller: �C�/ q c, l '�(=�T6_ casing <br /> liI height <br /> Consultant�� ni/� , rlS�7v �-+ <br /> Geologist �]P,. / Y' if �/Q°c <br /> ABOVE-GROUND CNRIS7Y=80X <br /> OcwLETION <br /> SPECIAL PERMIT INFO. 0 C*�Jnd gLe� COMPLETION <br /> Distance to sewer line 7�0� <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - <br /> L <br /> a <br /> — m <br /> C <br /> SAMPLING = <br /> uc5on — •� <br /> Holding Temperature <br /> Method — gnyeI pack <br /> Screening Method <br /> Tracking Sheet - (y/n) <br /> ft. = ft <br /> SPOILS /f- <br /> IJP <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type <br /> Slat size' Screen $' ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite . S <br /> Depth to water N �(�� Bags sand/graveI I R <br /> Mix Ratios Filter Pack type/sixe� I <br /> Installation Method Surge Block: - (y/n) <br /> Quantity Installed Discussed with geologist: - (y/ n) <br /> Type of method <br /> EH 29 29 <br />
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