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SR0087834_NITRATE LOADING STUDY ADDENDUM
Environmental Health - Public
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4200 – Liquid Waste Program
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SR0087834_NITRATE LOADING STUDY ADDENDUM
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Last modified
4/10/2024 4:36:36 PM
Creation date
4/10/2024 4:34:20 PM
Metadata
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Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
FileName_PostFix
NITRATE LOADING STUDY ADDENDUM
RECORD_ID
SR0087834
PE
4201
STREET_NUMBER
1153
Direction
S
STREET_NAME
GOLDEN STATE
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
15713034
ENTERED_DATE
3/19/2024 12:00:00 AM
SITE_LOCATION
1153 S GOLDEN STATE AVE
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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185 195 Clay Blue Swelling <br /> 195 200 Gravel Black Very Coarse <br /> 200 212 Clayey Sand Blue Silty <br /> 212 222 Sand Black Fine To Medium <br /> 222 228 Sand Black W/Gravel <br /> E228 234 Clay Blue Sandy <br /> 234 257 Sand Black Coarse <br /> 257 260 Clayey Sand Blue Dense <br /> z <br /> Casings <br /> Casing Depth from Surface Wall Outside Screen Slot Size <br /> # Feet to Feet Casing Type Material Casings Specificatons Thickness Diameter if any Description <br /> (inches) (inches) Type (inches) <br /> 1 0 160 Blank PVC OD:8.625 in.I SDR: 0.41 8.625 <br /> 21 1 Thickness:0.410 <br /> in. <br /> 1 160 240 Screen PVC OD:8.625 in.I SDR: 0.41 8.625 Milled 0.032 <br /> 21 1 Thickness:0.410 Slots <br /> in. <br /> 1 240 260 Blank PVC OD:8.625 in.I SDR: 0.41 8.625 capped end <br /> 21 1 Thickness:0.410 <br /> in <br /> Annular Material <br /> a <br /> Depth from <br /> Surface Fill Fill Type Details Filter Pack Size Description <br /> Feet to Feel <br /> 0 112 Cement 10.3 Sack Mix grout <br /> 112 260 Filter Pack Other Gravel Pack 3/16"x6 peagravel <br /> Other Observations: <br /> r � Borehole Specifications Certification Statement <br /> Depth from I,the undersigned,certify that this report is complete and aecurate to the best of my knMeoge and belief <br /> Surface Borehole Diameter(inches) Name R&M WATER WELL DRILLING&PUMPS INC <br /> Feet to Feet <br /> 0 260 14.5 Person,Firm or Corporation <br /> P O BOX 1329 VALLEY CA 95252 <br /> Address City State Zip <br /> Signed electronic signature received 11/12/2019 1017078 <br /> C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br /> DWR Use Only <br /> CSG# State Well Number Site Code Local Well Number <br /> I T1 I I I I N w <br /> Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br /> TRS: <br /> APN: <br /> Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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