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FIELD DOCUMENTS 1994-2010
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BEVERLY
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104
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2900 - Site Mitigation Program
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PR0540667
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FIELD DOCUMENTS 1994-2010
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Last modified
2/8/2019 8:40:52 AM
Creation date
2/7/2019 4:35:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
1994-2010
RECORD_ID
PR0540667
PE
2960
FACILITY_ID
FA0023252
FACILITY_NAME
WELDON CHURCH PROPERTY
STREET_NUMBER
104
Direction
W
STREET_NAME
BEVERLY
STREET_TYPE
PL
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
104 W BEVERLY PL
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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MONITORING WELL INSTALLATION RE_.._.(T <br /> Date: - I �� 1 gal CONSTRUCTION <br /> Premise Address: I t7Q 13eyez" Total Depth ZD <br /> /' Screen Length (from) 'Z-c-) -(to) <br /> Well No.: 2 ,11 ,,�F Filter Pack (from) (to) <br /> {� Bentonite (from) (to) <br /> Inspector: 1(. �1�1�1 Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> Completion - Stove pipe/ a box (2�ircle one) <br /> Drilling Company: Sok(__ ��PceA11cY� S(=P_lltiGl� <br /> Driller: 1 Z> casing <br /> Consultant vn�E3hX � C1� LKM V- <br /> Tr77 Iheight <br /> Geologist ?b"_L__ u..'au_ 71,•- T <br /> ABCVE-GROUND C8RlSTY-8CX <br /> COMPLETON COMPLE71CN <br /> SPECIAL PERMIT INFO. Ground Surf acs <br /> Distance to sewer line grout <br /> Domestic well on site - ( y/1 ♦3 ft. <br /> If yes, location and distance - ft. <br /> ft. <br /> O <br /> C <br /> O <br /> SAMPLING Blood f <br /> Bacton '— <br /> o \ — <br /> Holding Temperature 4 1 _ _ Gravel pads <br /> Method �►� m = <br /> Screening Method P1 t) <br /> Tracking Sheet - 4& n ) <br /> Z ft. = tL <br /> SPOILS / <br /> Storage Method n M 6t lr_a UNDI-.IG1 C�V� ?U Q MATERIALS/DEVELOPMENT <br /> Contamination Noted - fy>�n ) <br /> Storage Location n�f�rr� Casing type <br /> Blank t <br /> ft. Screen lS fr• <br /> Slot size o,02,0 <br /> GROUTING Bags cement <br /> i <br /> Buckets bentonite 6k� vJ0 <br /> Depth to water Bags sand/gravel <br /> Mix RatiosFilter Pack type/size SAYyD <br /> Installation Method F T9_17- Surge Block: - (y/-01" <br /> Quantity Installed Discussed with geologist: - (�/ n ) <br /> Type of method- � G I�J►nt th <br /> EH 29 29 <br />
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