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FIELD DOCUMENTS_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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6131
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3500 - Local Oversight Program
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PR0545003
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FIELD DOCUMENTS_FILE 1
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Last modified
11/27/2019 11:02:10 AM
Creation date
11/27/2019 10:54:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0545003
PE
3526
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
02
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REPORT <br /> Date: 10i/Z I p CONSTRUCTION <br /> Premise Address: -51 <br /> t Total Depth_ F p <br /> Screen Length (from) To (to) gp <br /> Well No.: Yb1 ULA j Filter Pack (from) 1�5 (to) <br /> Bentonite (from) �_(to)�� <br /> Inspector: ��tn �g Grout (from) o _(to) 4G ' <br /> L1 S Drilling rig type <br /> O <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: (-1c�a� <br /> Driller:__ ec1 � casing <br /> Consultant L VZ-/A- height <br /> Geologist S4nAt Q LQ A <br /> ABOVE-GFOUND <br /> COMPLETION CNAISTY-BO% <br /> SPECIAL PERMIT INFO. GroundSurface COMPLETION <br /> Distance to sewer line pran <br /> Domestic well on site - (y <br /> If yes, location and di nee - tt. <br /> - = m <br /> — o <br /> = m <br /> SAMPLING ebttad <br /> Becton = <br /> Holding Temperature rte 1 cp = <br /> Method <br /> Screening Me od <br /> Tracking Sheet - 'y/ n ) <br /> x = <br /> ft. r tt <br /> SPOILS <br /> Storage Method_ S MATERIALS/DEVELOPMENT <br /> Contamination Noted - n ) <br /> Storage LocationC)iA-,5l Casing type_ <br /> Blank 4l ft. Screen td ft. <br /> Slot size o Lri <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water IV 33 Bags san gravel ' <br /> Mix Ratios Filter Pack type/size--2L 1 z <br /> Installation Method Surge Block: - ( y nn ) <br /> Quantity Installed l t s — I f e Discussed with geologist: - ( y <br /> EH 29 29 Type of method <br />
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