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Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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501
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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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MONITORING WELL INSTALLATION REPORT <br /> Date: y /9• U ONSTRUCTION <br /> Premise Address: So/ Well No. 4: " <br /> Inspector:. —In'- L Total Depth 30 <br /> Screen Length s� <br /> filter Pack 2 $r <br /> Bentonite Pellets Z <br /> Permit No. rout ye/ <br /> Consultant -Completion-Stove pipe Christie bo <br /> Geologist <br /> 61 Auger O.D. l� <br /> Auger I.D. g <br /> SAMPLING - -- -- <br /> Holding Temperature etk*-up <br /> Method <br /> Screening Method o V M <br /> GROUND CHR�STY-BOX <br /> Tracking Sheet n 1+�L��N COMPLETION <br /> Ground Surface <br /> SPOILS <br /> grout <br /> Storage Method n. <br /> Contamination Noted - es no Z <br /> Storage Location S - <br /> SPECIAL PERMIT INFO. <br /> 0 <br /> Waited "E <br /> Distance to sewer line raGtiur! <br /> Domestic well on site -• yes � P <br /> If yes, location & distance - <br /> tt. ft. <br /> GROUTING <br /> 14ATERIALS USED: <br /> Depth to water O as ing type l�✓C <br /> Mix Ratios ! t3 lank ft. Screen ft. <br /> Installation M thod iot size <br /> Quantity Installed 3ags cement Z U <br /> uckets . ntonite <br /> ags an gravel S <br /> Filter Pack type/size # <br />
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