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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PERSHING
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4445
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2900 - Site Mitigation Program
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PR0541263
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Last modified
4/13/2020 1:59:47 PM
Creation date
4/13/2020 1:53:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0541263
PE
2950
FACILITY_ID
FA0023640
FACILITY_NAME
PERSHING GAS FOR LESS
STREET_NUMBER
4445
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95210
APN
11018006
CURRENT_STATUS
01
SITE_LOCATION
4445 N PERSHING AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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MONITORING WELL INSTALLATION REPORT <br /> Date: -71Iq O CONSTRUCTION <br /> Premise A drey�s• well No. W r <br /> 4445 fi, I't 4i t'j.(_ _ <br /> Inspector: Total Depth `L <br /> Jam• Screen Length -Z 5 <br /> Filter Pack Z <br /> Bentonite Pellets- Z Z� <br /> Permit No. - _ rfd — 1-70) Grout <br /> Consultant ICompletion--Stove pipe/christie box <br /> Geologist vim- ,e0'D/)U <br /> Auger O.D. y•2 �___ <br /> Auger I.D. „ <br /> SAMPLING <br /> Holding Temperature �C- <br /> Method CC L <br /> .ackwp <br /> Screening Method <br /> Tracking Sheet y n) <br /> Above-GROUND <br /> GOMPLEI'IaN C►WrSfY-GOX <br /> CCraPLE7lOf1 <br /> SPOILS &DwId S 0 <br /> prwl <br /> Storage Method � �L-' rn• <br /> Contamination Noted - yes h n. <br /> Storage Location — <br /> pLJ S c — <br /> do{�d c <br /> section <br /> SPECIAL PERMIT IA1F0, — <br /> Distance to sewer line 's — <br /> Domestic well on site - yes/ED_ <br /> If yes, location 6 distance - n• n. <br /> GROUTING "� MATERIALS USED: <br /> Depth to wa ✓ <br /> _ ter Casing type— <br /> Mix Ratios Blank ZS ft. Screen22 ft. <br /> Installation Method Slot size t9. J-2-0 <br /> Quantity I-natalled Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel <br /> Filter Pack type/size <br />
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