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FIELD DOCUMENTS_CASE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HAZELTON
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2900 - Site Mitigation Program
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PR0540905
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FIELD DOCUMENTS_CASE 2
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Last modified
2/3/2020 10:19:26 AM
Creation date
2/3/2020 9:23:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 2
RECORD_ID
PR0540905
PE
2960
FACILITY_ID
FA0023406
FACILITY_NAME
SIERRA LUMBER MANUFACTURERS
STREET_NUMBER
375
Direction
W
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
147120808
CURRENT_STATUS
01
SITE_LOCATION
375 W HAZELTON AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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MONITORING WELL INSTALLATION REPT <br /> Date: 1 7% CONSTRUCTION <br /> / <br /> Premise Address: ? 7f G✓ x/� yt ( (d Total Depth /49 <br /> V Screen Length (from) (to) <br /> Well No.: IeA,41 /C, X21/t/ /e/ Filter Pack (from) (to) <br /> / Bentonite (from)—(to)- <br /> Inspector: <br /> from) (to)Inspector: Grout (from) (to) <br /> Drilling rig type <br /> Permit N . 0 9 Auger O.D. I.D.- <br /> Drilling <br /> Completion- tove pipe/christie box (circle one) <br /> Company:/�1'4=cG'l <br /> Driller: �Ae; 7 casing <br /> height <br /> i <br /> Consultant,�6� <br /> Geologist .7 — jgp .GROUND <br /> CO l Sf1 IN 7rV=fX <br /> SPECIAL PERMIT INFO.S�' <br /> Distance to sewer lineDomestic well on site - (y/n ) . <br /> Ig <br /> If yes, location and distance - ff. <br /> n. y_ <br /> 7 <br /> x. <br /> _ m <br /> e <br /> C <br /> SAMPLING slatted '„ g <br /> tac�on §i = <br /> Holding emperature : = 4R P? <br /> Method ; _ <br /> Screen' g Method . <br /> Trac ' g Sheet - (y/n ) <br /> SPOILS / <br /> Storage Method MATERIALSEVELOPMENT <br /> Cont ar mation Noted - (y/n ) Q� <br /> Stora Location Casing type <br /> Blank ft. Screen fr. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios M 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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