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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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MONITORING WELL INSTALLP►TZON RF-PORT <br /> Date: <br /> CONSTRUCTION <br /> Total Depth (to) <br /> Premise Address: (/ Screen Length (from) <br /> Filter Pack (from) (CO) <br /> well No.. '��' J Bentonite (from) (C0) <br /> i� <br /> Grout (h•om) (Co) <br /> Inspector. i'� .Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/clui tie box (cLrde one) <br /> to <br /> an <br /> Drilling Com P T- <br /> casing <br /> Driller - he_ght <br /> Consultant <br /> Geologist AE E-GECUND <br /> CrJ Mr L_..�C iO tJ Gp},a?L-ilC N <br /> Grand Suixt <br /> SPECIAL PERMIT INFO. flea t <br /> Distance to sewer line". <br /> Domestic well on site = (y/ n) f?. <br /> If yes, location and distance - _ _ <br /> _ o <br /> � C <br /> O <br /> l I0 C.hj _ a <br /> SAMPLING i?C1CCl <br /> Holding Temperature } <br /> Method = <br /> Screening Method ; <br /> Tracking Sheet - (Y/ <br /> n. <br /> SPOILS <br /> M_A_T_ERI ALS/DEVELOPMENT <br /> Storage MethodS U <br /> Contamination Noted • (y/ n) Casing typePJB <br /> • Storage Location Blank ft.I I�oS�een <br /> Slot size 1 K16� <br /> Bags cement <br /> GROLMNG Buckets bentonite <br /> Bags sand/gr'vcl <br /> Depth to tvater Fuer Pack type/s <br /> Miz Ratios Surge Block: - f / <br /> ipstalladon Method Discussed with geologist: - (�y/ n) <br /> Quantity Installed Type of mctliod <br /> EH 29 29- <br />
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