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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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14900
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2900 - Site Mitigation Program
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PR0009023
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FIELD DOCUMENTS
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Last modified
11/19/2024 3:47:34 PM
Creation date
5/7/2020 3:57:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0009023
PE
2960
FACILITY_ID
FA0004091
FACILITY_NAME
TOWER PARK MARINA
STREET_NUMBER
14900
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242
APN
05503015
CURRENT_STATUS
02
SITE_LOCATION
14900 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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MOi ')RING WELL INSTALLATION RI:.PORT <br /> Date: Z� �3 CONSTRUCTION <br /> P-e:rise Address:f7'/� ��l°stw� `Z,�t .t Total Depth Z <br /> �� Screen Lansh (from) Z (to) 1 F5 <br /> Well No.: �I Filter Pack (from) 22 (to) la. <br /> Bentonite (from) 10 (to) 8 <br /> Insoec-or. Grout (from) & (to) o <br /> Drilling rig type <br /> Per^,.ic No, Auger O.D. � <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company-.4�� �� <br /> /q��//� casing <br /> Driller: C.RA e-G. II � height <br /> Q J <br /> Consultant P +�/ <br /> Geologist TG- 'e �15OV:-GAOtrND CNAtSTy- <br /> 3CX <br /> CJM?C=►fCN � _ <br /> Ground Sutxa <br /> SPECIar ?Et?-WT INFO. <br /> grout <br /> Distarce to sewer line S <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - 1 tL <br /> � <br /> �'S ft. <br /> o � v <br /> sbttad :i% = e <br /> SAMPLING sectionZvi x <br /> pack <br /> Eloldirig Temperature � <br /> .ti. �_ <br /> Method ��- <br /> Screening Method <br /> Tracking Sheet - (y/ n ) 22 ,L ♦ <br /> SPOILS <br /> Storage Method MA iaRIALS/DEVELOPMEN'I' <br /> Contamination Noted - (y/n) 2�� PYA <br /> Storage Location Casing�e <br /> Blank ILS fc. Screen 10.5 ft. <br /> Sloc size O <br /> GROUTING Bags cement <br /> Buckets bentonite ' 2 <br /> Depth to water ��• _ Bags sand/gravel <br /> Mix Ratios Filter Pack type/size L <br /> Ins:alIadon Method Surge Block: - (y/nn <br /> Quandcy Installed Discussed with geo ogist: - n) <br /> Type of method <br />
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