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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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PR0545688
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Last modified
11/29/2021 11:54:05 AM
Creation date
5/21/2020 9:41:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545688
PE
3528
FACILITY_ID
FA0003634
FACILITY_NAME
CANTEEN CORPORATION
STREET_NUMBER
1500
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14326008
CURRENT_STATUS
02
SITE_LOCATION
1500 N SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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\ SOMQNITORING WELL INSTALLATION REP <br /> l <br /> Date: CONSTRUCTION <br /> � ^ <br /> Total Depth (OCJ <br /> Premise Address: /!52JX~D S� Screen Length (from) (to) — <br /> Well No.: lr Filter Pack (from) D (to) _ <br /> Bentonite (from) (to) <br /> Grout (from) <br /> Inspector: <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> E Completion - Stove pipe/chrislie box (circle one) <br /> Drilling <br /> Compnany: ' <br /> Driller: __ cas ing <br /> height <br /> Consultant = <br /> Geologist Azd <br /> ABOVE-GROUND CHR <br /> COMPLE CN ON <br /> SPECIAL PERMIT INFO. Grourid Surlaca <br /> Distance to sewer line K111Grout <br /> Domestic well on site - (y/ n <br /> If yes, location and distance - ft. <br /> J J <br /> o <br /> SAMPLING _ <br /> alottad � c <br /> N. <br /> Holding Temperature G _ gm�pack <br /> Method ` — <br /> Screening Method 6V'*- <br /> Tracking Sheet - y n ) — <br /> SPOILS C 1 <br /> Storage Method �/ MATERIALSZDEVELOPMENT <br /> Contamination Noted - y n ) <br /> Storage Location A Casing type z� V _ <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite l <br /> Depth to water -53 Bags sand/gravel 7-+ T� <br /> Mix Ratios - f° If Filter Pack type/size 3 <br /> Installation Method Surge Block: - (y n } <br /> Quantity Installed Discussed with geologist: <br /> - (y/n ) <br /> EH 29 29 Type of method <br />
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