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WP0039973
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039973
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Last modified
3/5/2020 3:06:06 PM
Creation date
3/5/2020 2:38:36 PM
Metadata
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Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039973
PE
4372
STREET_NUMBER
17001
Direction
S
STREET_NAME
MCKINLEY
STREET_TYPE
AVE
City
LATHROP
Zip
95023-
APN
19818008
ENTERED_DATE
8/16/2019 12:00:00 AM
SITE_LOCATION
17001 S MCKINLEY AVE
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter Type if any Description <br /> (inches) (inches) (inches) <br /> Annular Material <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feet <br /> 0 1 91.5 Cement Portland Cement/Neat Cement <br /> Destruction Details: <br /> geotechnical investigation boring backfilled with neat cement grout,inspected by Aaron Gooderham on 9/5/2019 <br /> Other Observations: <br /> Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief <br /> Surface Borehole Diameter(inches) Name PITCHER SERVICES LLC <br /> Feet to Feet <br /> 0 91.5 3.875 Person,Firm or Corporation <br /> 2726 Walnut Avenue Signal Hill CA 90755 <br /> Address City State Zip <br /> Signed electronic signature received 09/17/2019 1044895 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <br /> N W <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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