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Page 1 of 1 <br /> Vicki McCartney [EH] <br /> From: Vicki McCartney [EH] <br /> Sent: Wednesday, June 19, 2013 3:31 PM <br /> To: 'Steve Carter <br /> Subject: Masterfile Record (MFR)form <br /> Attachments: MFR.pdf ' <br /> Steve, <br /> This is the Master File Record (MFR)form that you need'to submit with the well destruction permit application. As <br /> mentioned today during our telephone conversation, whomever signs the MFR form is responsible for fees that <br /> exceed the amount submitted with.the well destruction permit application. Please remember to include the tax ID <br /> #. (The shaded area on the form is for internal use.) <br /> When destroying MW-6, the conductor casing may remain in place; however, the 2-inch diameter Schedule 40 <br /> PVC casing, filter pack, and grout between the PVC casing and metal conductor casing must be removed and the <br /> borehole filled from total depth of approximately 64 feet bsg to surface with 10.3 Sack sand/cement grout, forming <br /> a"mushroom cap" at approximately three feet bsg. <br /> Please do not hesitate to call me if you have any other questions concerning well destructions. <br /> Vicki McCartney, Senior REHS <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue <br /> Stockton, California 95205 <br /> Phone: (209)468-9852 <br /> Email: vmccartney(a-sjcehd.com. <br /> 6/19/2013 <br />