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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOUNTAIN HOUSE
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23577
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2900 - Site Mitigation Program
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PR0522619
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Last modified
8/17/2019 4:25:16 AM
Creation date
8/16/2019 11:55:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522619
PE
2950
FACILITY_ID
FA0015410
FACILITY_NAME
CHARLIE SPATAFORE PROPERTY
STREET_NUMBER
23577
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
TRACY
Zip
953049600
APN
20908026
CURRENT_STATUS
01
SITE_LOCATION
23577 MOUNTAIN HOUSE PKWY
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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*ITORING WELL INSTALLATION REPO ^ <br /> Date:�/9 _2-01641 CONSTRUCTION <br /> Premise Address: Total Depth Soi t /h r <br /> ��/��� c�� / Screen Length (from) (to) <br /> Well No.-, eg a4, PA^' _<O ' °Q G w Filter Pack (from)—(to)— <br /> Bentonite <br /> from) (to)Bentonite (from) (co)— <br /> Inspect.or <br /> to)Inspector. � ^^'` Grout (from) (to) <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D: <br /> _ A , Completion - Stove pipe/cluistie box (circle one) <br /> Drilling Company: f,,, i <br /> Driller: casing <br /> 7F <br /> height <br /> Consultant/� k ^ ^�� <br /> Geologist [.4``t4 SI-1- <br /> ABOVE-GRCUND GtiAtStY-30X <br /> CCNPLETICN OVAPLc-TION <br /> Gcvj <br /> SPECIAL PERMIT INFO. '�— r-4 S "y + <br /> prart <br /> Distance to sewer line A1A 11 <br /> Domestic well on site - (y <br /> If yes, location and distance - ft. <br /> ft. _ <br /> - C <br /> O <br /> SAMPLING slotted <br /> D� soc'cn — <br /> Holding pera e = tx+ <br /> Method N <br /> Screening Y&od e) _ <br /> Tracking Sheet - } / n) • <br /> l/ ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contaminadon Noted - y n) o <br /> Storage Location Casing e � Screen —f. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Rados 1 Facer Pack type/size <br /> stallation Method 1 eli 3D «� " ° Surge Block: - (y/n ) <br /> Quantity Installed Discussed with geologist: - (y/ In) <br /> Type of method <br /> EH 29 29 <br />
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