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WORK PLANS_FILE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HAMMER
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1612
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3500 - Local Oversight Program
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PR0545246
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WORK PLANS_FILE 2
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Last modified
1/30/2020 3:44:13 PM
Creation date
1/30/2020 1:54:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
FileName_PostFix
FILE 2
RECORD_ID
PR0545246
PE
3528
FACILITY_ID
FA0003611
FACILITY_NAME
PARKWOODS GAS & FOOD
STREET_NUMBER
1612
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
07728002
CURRENT_STATUS
02
SITE_LOCATION
1612 W HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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AF Il <br /> .: NITORING WELL INSTALLATION REPOIJ <br /> I <br /> n _ i, J _ f <br /> C <br /> Date: CONSTRUCTION <br /> Premise Address: Total Depth <br /> " <br /> ff Screen Length (from) (to) <br /> Well No.:_F�J � :, -_ Filter Pack t (from) (to)�� <br /> Bentonite (from) (to) <br /> Inspector: Grout Ih (fro (t�A <br /> Drilling rig-jqme r� <br /> Permit No. Auger O.D.i <br /> f; Completioria-Stove pipe/ kris a boy circle one) <br /> Drilling Company: <br /> Driller: PNQ casing <br /> - Ti height <br /> j Consultant <br /> Geologist �.� <br /> AXFO r-GF1CUND <br /> _ CQMPI.ETfON CHR4309 <br /> COMP Ef1CN <br /> SPECIAL P T INFO I C3=r{d Swfaco <br /> L �1k <br /> Distance to sewe ine Qrout I <br /> j� <br /> Domestic well on #i (y n ij ft, <br /> If yes, location an i nce - tL <br /> SAMPLING j alorvd G <br /> iedcn = <br /> Holding Tem erature �a/AI, ,I <br /> Method <br /> 9M Pack <br /> Screening Method <br /> Tracking Sheet ( n) <br /> SPOILS <br /> �a <br /> Storage Method MAT RIALS/DEVELOPMENT <br /> Contamination Not ( <br /> Storage Location Casing typet <br /> 2D- .. <br /> v rll__— Blank ft. Screen <br /> SIot size 3 <br /> f GROUTING _ Bags"cement <br /> Buckets bentonite ' <br /> Depth to water Bags''sand/gravei <br /> Mix Ratios Filter Pack type/size <br /> Installation Method---_ Surge Block: -' y/ n ) <br /> Quantity Installed Discussed with Oologist: - y n } <br /> Typeof method <br /> EH 29 29 <br />
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