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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0518875
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Last modified
11/12/2019 3:32:58 PM
Creation date
11/12/2019 3:15:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0518875
PE
2960
FACILITY_ID
FA0014182
FACILITY_NAME
FORMER BUSY BEE CLEANERS
STREET_NUMBER
40
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
40 N MAIN ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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%NITORING WELL INSTALLATION REft <br /> Date: 6� CONSTRUCTION <br /> Premise Address: Total Depth <br /> / Screen Length (from) (to) <br /> Well No.:..4- Filter Pack (from) (to) <br /> Bentonite (from) (to) <br /> Inspector: ,/ Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant "�r <br /> Geologist�e;.., l /L Ct c.� •- T <br /> l ABOVE-GROUND CHRISTY480X <br /> COMPLETION COMPLETICN <br /> SPECIAL PERMIT INFO. Ground Surface -- <br /> Distance to sewer line grout <br /> Domestic well on site - (y/ n ) 6_57 <br /> If yes, location and distance - ft' <br /> 71S_ <br /> — o <br /> SAMPLING dotted <br /> ssc1on —_ <br /> Holding Temperature = 73vol pack <br /> Method = <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing type/ KU <br /> Blank ft. Screen ft. <br /> Slot size C,% 7 7 r-) <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Ivue - _ Filter Pack type/size <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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