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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LOUISE
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1196
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3500 - Local Oversight Program
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PR0545438
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Last modified
3/9/2020 2:51:53 PM
Creation date
3/9/2020 1:17:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545438
PE
3528
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
02
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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MONITORING W-zT.:INSlA LTA-LION REPORT <br /> Date: CONSTRUCTION <br /> Premise Andress: , 1 CIL i A nom,.( CA I' Total Depth <br /> Screra Length (from) A•5 (to) <br /> 'Filter Pack (from) R' (to)—q.'5 <br /> Well No. ffiA`L� ' <br /> Bemmnite (frot¢),_ �- (to) � <br /> Inspector: Lla A,. n<" <br /> Grout (from) (to) ' <br /> DrMing rig type <br /> Permit No. 0 1<R Auger O.D. <br /> Completion-Stave pipe/ a box (circle one) <br /> DnMing Company- s�_r�t <br /> ♦ -S�c <br /> COT15111LdIIt <br /> Geologic CVSC-,RC <br /> �" �r !S Y-aCX <br /> SPECIAL Pte?VR"INPO. Gcx�s�SZ-'a^Y A <br /> , <br /> Distance to sewer line 1 <br /> Domestic well on site - ---�•/--`- <br /> If yes; location' and d stance - Qb�- <br /> - e <br /> � C <br /> A. <br /> •' O <br /> SANTUNG <br /> Holding Tempore — ;m..*pack <br /> Method 4," 6'au, <br /> Screening Method = <br /> Tracking Sheet n) - <br /> SPOILS <br /> Storage Method MA=ALS/DEV'i-OPMEN-f <br /> Contamination Noted - (y/®) casing <br /> t9Pe 2 Qy - <br /> Storage Loczrion�;�_y�.(-�t, <br /> Blank Q fL Screen 1 S� fL <br /> Slot size O O <br /> GROU-I TNGBags cementZ- <br /> �wfa�inn caf Bucke= beatonite '12- <br /> Dept to ware N l 13 C( �10 �` �'�u Bags sand/grave? <br /> Mia Ratios 06 zi - 'Filter Pack type/size o� 2 <br /> Iastallarion Memo S=-,e Blodc - (q/0$) <br /> Disc <br /> Quantity Irsmlled Discussed with geologist: n <br /> - ( / ) <br /> ^51 k9 Type of method <br /> _H 29 29 <br />
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