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FIELD DOCUMENTS
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:--- CONSTRUCTTON <br /> Premise Address: ,S-01 Well No. V 7 <br /> Inspector:_-4, { Total Depth s <br /> 61 <br /> Green Length S's <br /> filter Pack <br /> entonite Pellets 8•-1 <br /> Permit No. rout - ` <br /> Consultant=-- <br /> onsultantCompletion-Stove pipe/ hristie box <br /> Geologist <br /> Auger 0.D. 70 " <br /> Auger I.D. .._ <br /> SAMPLING _.._. <br /> 0 <br /> Holding Temperature_ C• _ •tk*-up <br /> Method <br /> Screening Method__ O ✓ T <br /> -GROUND CHRISTY-BOX <br /> —W <br /> Tracking Sheet ( n� MPLETION COMPLETION <br /> Sudace <br /> SPOILS T <br /> �� � grout <br /> Storage Method_ S'7tc�C� --rL! � y <br /> Contamination Noted - yes no n• <br /> Storage Location�yr_ sr � n• <br /> m <br /> A <br /> SPECIAL PERMIT INFO. <br /> a <br /> c <br /> Distance to sewer line N A wctian = B <br /> Domestic well on site - yes/T� — 9mvel <br /> park <br /> If yes, location & distance <br /> GROUTING <br /> TERIALS USED; <br /> Depth to water N//1 asing type Yr/7" �RD Svc - le All <br /> Mix Ratioslank /d ft. Screen S!-:�' ft. <br /> Installation Aethod 31ot size o. O 6'- <br /> Quantity <br /> Quantity Installed 3ags cement <br /> uckets bentonite L <br /> agsn/gravel_ 3� <br /> filter ack type/size w1A <br />
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