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FIELD DOCUMENTS_FILE 2
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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PR0541875
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FIELD DOCUMENTS_FILE 2
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Last modified
3/16/2020 4:48:50 PM
Creation date
3/16/2020 2:05:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 2
RECORD_ID
PR0541875
PE
2960
FACILITY_ID
FA0024017
FACILITY_NAME
CHEVRON SITE 306415
STREET_NUMBER
437
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95202
APN
1392417
CURRENT_STATUS
01
SITE_LOCATION
437 E MINER AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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• <br /> MONITORING WELL, INSTALLATION REPORT <br /> Date: <br /> CONS��ON <br /> Premise Address: <br /> Well No.: Total Depth <br /> Screen Length (from) <br /> Inspector: Filter Pack (from)-��-(W)_ <br /> Bentonite <br /> Ur <br /> Grout <br /> Permit No. Grout <br /> Drilling rig type ) <br /> �----(to)----- <br /> Drilling Com Auger O.D. <br /> Pant: Completion - S� I'D- <br /> Drler: Stove P /christie—x (circ—e on <br /> _ <br /> e) <br /> 6 : <br /> Consultant casing <br /> height <br /> Geologist <br /> ABOVE-GROUND <br /> SPECIAL PERMIT INFO. COMPLETION C�1STl 80X <br /> Distance to sewer line —�Ground sLrfaca CZ P-..nO_ <br /> Domestic well on site - (y <br /> If yes, location and distance <br /> h. <br /> Y� •- � a <br /> SAMPLING <br /> Holding Temperature cloned <br /> Method s0(77on 14 — $ <br /> y: <br /> Screening Method _ , <br /> Tracking Sheet - (y,/n) <br /> V91 Pack <br /> a = <br /> SPOILS <br /> h. <br /> Storage Method <br /> Contamination Noted - (y/n ) MgTERi <br /> Storage Location AUS/DEVELOPMENT <br /> Casing type <br /> GROUS <br /> TING <br /> Blank <br /> - ---_—ft. Screen <br /> Slot s —ize <br /> Bags cement <br /> Depth to water <br /> Buckets bentonite <br /> Mix Ratios Bags sand/Sravel <br /> Installation Method Filter Pack <br /> Quantity Installed Surge Block;t. - C size <br /> (y/n—) <br /> EH 29 29 <br /> Discussed with geologist: - (y/n) <br /> Type of method <br />
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