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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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25700
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2900 - Site Mitigation Program
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PR0508450
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Last modified
5/29/2019 11:42:43 AM
Creation date
5/29/2019 11:07:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508450
PE
2960
FACILITY_ID
FA0008087
FACILITY_NAME
DDJC-TRACY
STREET_NUMBER
25700
STREET_NAME
CHRISMAN
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25207002
CURRENT_STATUS
01
SITE_LOCATION
25700 CHRISMAN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REPORP <br /> Date:�I2 I D3 /� CONSTRUCTION <br /> Premise Address: 2�'loo / Imo`+ Total De th <br /> l.(nr-�S�-.�- _ P <br /> Screen Length (from)—(10)— <br /> Well <br /> from) (to)Well No.: Filter Pack (from) (to) <br /> y Q Bentonite (from) (to) <br /> Inspector•. Grout (from)—(to)— <br /> .Drilling <br /> from) (to).Drilling rig type <br /> Permit No. Auger O.D. I.D. <br /> 9 •' _ \ Completion - Stove pipe/clu-istie box (circle one) <br /> Drilling Company: �'O� <br /> Driller: casing <br /> rr height <br /> Consultant "� � r <br /> Geologist JSgOVEGRCUND <br /> CONFLETCN C0&1Pt=nCN <br /> COt,4PLETICN <br /> SPECIAL PERMIT INFO. Ground S '� <br /> s9, <br /> Distance to sewer line J ol.I-I SAH . grout <br /> Domestic well on site - (y/ n) Ln 041"A <br /> If yes, location and distance - / h. <br /> P <br /> - C <br /> O <br /> SAMPLING tlorai <br /> suc'cn — <br /> Holding Temperature al F'4k <br /> Method <br /> Screening Method = <br /> Tracking Sheet - (y/ n) <br /> SPOILS L <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n) `11�'f� rS� <br /> Storage Location Casing type 7 <br /> g Blank fc. Screen_-----------ft. <br /> Slot size 0. 0 <br /> GROUTING Bags cement <br /> Buckets bentonite -- <br /> Depth to water Bags sand/gravel -z 1'2,- <br /> Mix Ratios Filter Pack type/ ' e i-z- <br /> Installation Method Surge Block: - n ) <br /> Quantity Installed Discussed with cologist: - 601 n ) <br /> Type of method <br /> EH 29 29 <br />
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