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2900 - Site Mitigation Program
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PR0540667
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Last modified
2/8/2019 8:34:05 AM
Creation date
2/7/2019 5:05:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
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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17EC'EiVE� <br /> ACCESS AGREEMENT <br /> Well Destruction <br /> 42 West Beverly Place, Tracy, California, 95376 <br /> (APN: 233-153-14) <br /> I, Juan or Maria Ibarra, the property owner of parcel 233-153-14, do hereby grant <br /> permission to Advanced GeoEnvironmental, Inc. (AGE) on behalf of the responsible <br /> party, Weldon Church, to destroy one (1) groundwater monitoring well under San Joaquin <br /> County Environmental Health Department permit at 42 West Beverly Place, Tracy, <br /> California, 95376.The site under investigation is located adjacent to the above referenced <br /> property at 104 West Beverly Place, Tracy, California. The proposed work is being <br /> performed under the directive of the San Joaquin County Environmental Health <br /> Department. The scope of work will include the following: <br /> • Destruction of one (1), 2-inch diameter groundwater monitoring well.The casing of <br /> well MW-7 will be filled with neat cement and pressure will be applied to the casing <br /> in order to force cement through the screened interval and into the borehole and <br /> surrounding formation. The well box and top three feet will be removed and the <br /> remaining well casing will be filled with cement. The remaining borehole will be <br /> backfilled to surface grade with neat cement and covered with concrete, asphalt, or <br /> native material (soil or grass) depending on the surrounding surface material. <br /> • The surface will be returned to the original condition as best as it can. <br /> All expenses for the well destructions performed at 42 West Beverly Place, Tracy, <br /> California shall be paid by the responsible party(Weldon Church), and shall be conducted <br /> under permit and in accordance with local regulations. <br /> Reporting of the proposed work at your property will be forwarded to you the property <br /> owner. <br /> We will provide 48 hours notice prior to the initiation of field activities, which shall be <br /> conducted in a manner to minimize disruption to the property. Please provide your phone <br /> number below so we can contact you to schedule the work. <br /> ' I <br /> `fig/:='" �•'I-��C I; - <br /> Juan'or Maria Ibarra Date <br /> 42 West Beverly Place <br /> Tracy, California, 95376 <br /> Phone Number: <br />
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