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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0518340
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Last modified
5/21/2020 3:39:09 PM
Creation date
5/21/2020 3:03:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0518340
PE
2960
FACILITY_ID
FA0013845
FACILITY_NAME
CHEVRON FACILITY #35-2515
STREET_NUMBER
401
Direction
N
STREET_NAME
SAN JOSE
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13526016
CURRENT_STATUS
01
SITE_LOCATION
401 N SAN JOSE ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
TSok
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EHD - Public
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MONITORING WELL INSTALLATION REPOrni <br /> Date: N6 dy- O , CONSTRUCTION <br /> Premise Address: T ��/ -�JTotal Depth /7 <br /> Screen Length (from) (to) <br /> Well No.: Filter Pack (from) !7 (to) S <br /> Bentonite (from) 5 (to) 3 <br /> Inspector: Grout (from) (to) <br /> / Drilling rig type <br /> 6 <br /> Permit No. / 2'F Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist lA T <br /> ABOVE-GROUND <br /> COMPLETION C4iRISTY-BOX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Suriaca <br /> Distance to sewer line Ofoul <br /> Domestic well on site - ( y/ n ) 3 <br /> If yes, location and distance - ft. <br /> s ft. <br /> _ m <br /> = u <br /> mc <br /> f: <br /> slotted <br /> socton <br /> Holding Temperature <br /> 9r2V1W Pack <br /> Method = <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) _ .s <br /> ft. ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) It /)/e <br /> Storage Location Casing type 14 <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> 2Gay Btu bentonite ` <br /> Depth to water 3 / Bags sand/gravel 3:50 <br /> Mix Ratios Filter Pack type/size l Z- <br /> Installation Method Surge Block: - (y� <br /> Quantity Installed Discussed with geo ogist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br /> //- ,P- 16 ��/ <br />
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