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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2219
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2900 - Site Mitigation Program
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PR0508387
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Last modified
5/26/2021 7:42:46 PM
Creation date
5/26/2021 11:20:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508387
PE
2960
FACILITY_ID
FA0008052
FACILITY_NAME
CONNELL MOTOR TRUCK
STREET_NUMBER
2219
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11736029
CURRENT_STATUS
01
SITE_LOCATION
2219 N WILSON WAY
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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M—.-OTORING WELL INSTALLATION REPOh. <br /> Date��t �"^ �3t Zoos CONSTRUCTION <br /> Premise Address: <br /> ZM7 �// �, G(/�reK Total Depth ?,b0 <br /> Screen Length (from) /q (to) Zpy <br /> Well No.: J Filter Pack (from) (to) 2-06 <br /> Bentonite (from) $ (to) L <br /> Inspector: Grout (from) (to) O <br /> C� Drilling rig tvoe <br /> Permit No. / Auger O.D. — I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: ��� (o'� 44L' !Oo—2�o <br /> �`� CG 0 — /00 <br /> Driller: �Id� t 2" casing <br /> height <br /> Consultant G T <br /> Geologist %v"�' AgpyE AROUND �,�X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surfacs <br /> Distance to sewer line <br /> .. 7Z57 grout <br /> Domestic well on site - Q`n ) n• <br /> If yes, location and distance - /9 3 ft- <br /> 3�po' � 5 ft. <br /> a <br /> = a <br /> _ o <br /> SAMPLING t1O <br /> Bacton <br /> Holding Temperature = g"'q�Pack <br /> Method = <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) <br /> ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( / n ) <br /> Casing type <br /> Storage Location <br /> Blank ft. Screen �• <br /> Slot size '0.2.0 <br /> GROUTING Bags C <br /> Buckets bentonite G N�C <br /> Depth to water = 2' Bags sand/gravel <br /> Mix Ratios 'JD Filter Pack type/size <br /> Installation Method Surge Block: - (YC) <br /> Quantity Installed 407-5 Discussed with geologist: - ( y kn <br /> Type of method <br /> EH 29 29 <br />
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