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Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545337
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Last modified
2/11/2020 8:09:10 PM
Creation date
2/11/2020 11:26:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545337
PE
3528
FACILITY_ID
FA0003629
FACILITY_NAME
ARCO STATION #434*
STREET_NUMBER
501
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03119028
CURRENT_STATUS
02
SITE_LOCATION
501 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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r <br /> - max,,•" „bf <br /> MONITORING WELL INSTALLATION REPORT <br /> Date• 171- ?o CONSTRUCTION <br /> Premise Address: sat . �i�f� Well No. �' 8 <br /> Inspector• LN. - LO(, 9otal Depth .5.-r <br /> Screen Length <br /> ilter Pack - <br /> entonite Pellets - <br /> Permit No. Crout <br /> consultant iEo...j s C QCompletion-Stove pipe/ riatie box <br /> Geologistxzza H'zn� <br /> Auger O.D. /C) <br /> iAuger I.D. <br /> SAMPLING _. <br /> Holding Temperaturey° <br /> Method C sUGc•up <br /> T <br /> T7 <br /> Screening Method 7�-Z ,/ T <br /> NE-GROUND CHRISTY-BOX <br /> Tracking Sheet {y n) COMPLETION COMPLETION <br /> Ground Suftc* <br /> SPOILS <br /> �. ptbut <br /> Storage Method !v , � y <br /> Contamination Noted - yes/no L • <br /> Storage Locati.on_adC v A& n• <br /> p <br /> SPECIAL. PERMIT INFO. <br /> 0 <br /> Distance to sewer line mon <br /> Domestic well on site - yes/no WP <br /> ack <br /> If yes, location & distance - <br /> GROUTING <br /> 14ATERIALS USED; <br /> si <br /> Depth to water Irl acing type_PVC SCh/ So - V <br /> Mix Ratios—LAt, alank /0 ft. Screen y-s -ft. <br /> Installation Method f,<o- �lot size D - ov" <br /> Quantity Installed 3ags cement 2 <br /> uckets bentonite <br /> a g s and gravel 20 3/ <br /> filter Pack type/Bize_LMW 21mq <br />
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