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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
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EHD - Public
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MONITORING Wr-..L INSTAIJAMON REPORT <br /> 6 <br /> Date- <br /> CONSTRUCTION <br /> Premise Address: 11°i LJ l all Total Depth a 5 <br /> rnnNy1 <br /> Screen Length (from)_— <br /> Well 230.: �n 1�' Z-- Filter Pack (from) FS (to) — <br /> Benronite (from) (to) g <br /> Inspector. <br /> Grom (from) (to) <br /> Dulling rig type <br /> Petmir No. C-) I `� + Anger O.D. :S I.D. <br /> Campietioa-Stove pip �risve o (circle one) <br /> Dnlliag Company- �^'r'1�s,a.�P,e=. <br /> Dn11er: FT A <br /> Consultant �•�, <br /> GeoloG CUND ,y-c3CXC-Cx <br /> =6F'---ZN <br /> SPECIAL PE?M?"TWO. CV=Xd sutaos <br /> Distance to sews:line <br /> Domestic well on site - <br /> Lf yes, location and dismnce - <br /> SAMPLING �O <br /> soman - � <br /> 'Holding Tema <br /> Method <br /> Screening Method --nv Y^-t <br /> Tracidng Sheet <br /> 25 ,� T _ — r►_ x 5 f <br /> M ` <br /> SPOILS <br /> Storage Method S S MA7=MLALS/DEVELOPWENT <br /> Contamination Noted - (y(n7) Casin <br /> Storage Location ^ -:41g <br /> glanlc fr. Screenfr- <br /> Slot size__L o 7�U <br /> GROUTING Bags cement Z <br /> �vN u o Buckets bentonite 1 <br /> Dept*. to ware_- 'v 1 3 '� cnyt�uJ <br /> Bags sznd/grave <br /> Mia Rarios F 11te:Pack type/ <br /> size - <br /> Insrailarion Meth d Stage Block: - (y/®) <br /> Quaatiry t,.raTted Discussed with geoiog= - 0/ n ) <br /> Type of method <br /> I <br /> . 2929 <br /> �..i, `0/ <br /> 1 <br />
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