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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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THORNTON
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14749
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2900 - Site Mitigation Program
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PR0507155
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Last modified
5/8/2020 9:54:48 AM
Creation date
5/8/2020 9:43:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0507155
PE
2950
FACILITY_ID
FA0007718
FACILITY_NAME
3 B'S TRUCK PLAZA
STREET_NUMBER
14749
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05515026
CURRENT_STATUS
02
SITE_LOCATION
14749 N THORNTON RD
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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�. *4/ <br /> MONITORING WELL,INSTALLATION REPOn f <br /> Date: der �fl -----------_____ CONSTRUCTION <br /> Premise Address: (u t� / isQ A&1 U',rJ tt uJf 0 �•�?) Total Depth '2S a2 4- <br /> �p Screen Length (from) S F-I (to) 25 FT <br /> Well No.: /�W- N Filter Pack (from) (/FT (to) 2 s f I <br /> -f Bentonite (from) 2 F;' (to) It F-7 <br /> Inspector: ; Ar-1 r'++ t} Grout (from) I f-t- (to) 2 /--T <br /> Drilling rig type G•.A F_ -7S <br /> Permit No. "` T a Auger O.D. b 1, " I '/ ' <br /> Completion - Stove pip c istie bcircle one) <br /> Drilling Company: �1V S#� A,^5 E Y+c+� oa <br /> Driller: I' ;6s. KI) Po ncasing <br /> Consultant <br /> .�A cv6N�4fJ GJSQ t 1t7 �{ T(., ABO-VEGROUND height -_ T <br /> Geologist WT <br /> CHRLST,+,-Box <br /> COA�PLEfbN COMPL.E= <br /> SPECIAL PERMIT INFO. Gewnd Sumac+ <br /> btPgtpx. 25 + � _ <br /> Distance to sewer line SYp4iC T4"Jf'� �+ )+ 5 Qfout <br /> Domestic well on site - U)/ n) . <br /> If yes, location and distance - 1W 94ttL <br /> —T — <br /> Sc' j Tfj 1e14>i — 'a <br /> — o <br /> — o <br /> SAMPLING slotted = S <br /> sedon _ <br /> Holding Temperature t +A# — LIQ Paci� <br /> Method nriN <br /> Screening Method AjiA w = <br /> Tracking Sheet - (y/ n) a+;A tL <br /> SPOILS <br /> Storage Method ';5 !!�E,/�� D12iv,M5 __- MATERIALS/9EVLOPMENT <br /> Contamination Noted - (y � uF 1� > t(rC <br /> 5L,Storage Location SnT.s;_p r Min; -M9r'Y•S} Casing type J`t y'tc•c�v�R <br /> Blank ft. Screen Z O ft. <br /> Slotsize O 112•- 11cN <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water �1 Bags sand/gravel <br /> Mix Rados Filter Pack type/size L%) trt 3 <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />
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