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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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19855
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2900 - Site Mitigation Program
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PR0524543
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Last modified
1/24/2020 3:43:41 PM
Creation date
1/24/2020 3:35:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0524543
PE
2965
FACILITY_ID
FA0016464
FACILITY_NAME
MT HOUSE STORMWATER PONDS
STREET_NUMBER
19855
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95391
APN
20906031
CURRENT_STATUS
01
SITE_LOCATION
19855 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REPO <br /> Date: /Z, ZOO`'j- �►.(p� CONSTRUCTION <br /> ` / I <br /> q <br /> Premise Address: !l el-1 UC a Total Depth <br /> ikw AIA/ ;bL?Q(i6 'y/ Screen Length (from) (to) <br /> Well No.:AA'¢ Filter Pack (from) (to) <br /> n / _ Bentonite (from) (to) <br /> Inspector: �x�1"T Grout (from)-(to)- <br /> Drilling <br /> from) (to)Drilling rig type <br /> Permit No._ d3 PSS_ Auger O.D. I.D. <br /> Drilling <br /> Co ove pipe hristie box (circle one) <br /> Company: 0 �/ G[/ <br /> Driller: / "� t r casing <br /> height <br /> Consultant <br /> Geologist <br /> ABOVE-GROUND <br /> COMPLETION CHRIS7Y-80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Chou Surface <br /> r <br /> Distance to sewer line �SCS grout <br /> Domestic well on site - ( y n Q IP 194 wo _ ft. <br /> If yes, location and distance - 2/-:;0 r ft. <br /> = a <br /> = m <br /> a <br /> C <br /> SAMPLING = ° <br /> Boned <br /> on <br /> Holding Temperature _ gmW pack <br /> Method <br /> Screening Method _ <br /> Tracking Sheet - n ) 6/0-6' F, <br /> Ott. <br /> SPOILS <br /> Storage Method t„ MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y n t pJC <br /> Storage Location Casing type Z f <br /> Blank R., Screen 10 ft. <br /> Slot size 010 <br /> GROUTING Bags cement <br /> _ Buckets bentonite Liw <br /> Depth to water rJS Bags sand/gravel <br /> Mix Ratios Filter Pack type/size 2 I Z <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed Discussed with geologist: - (y ACD <br /> Type of method <br /> EH 29 29 <br />
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