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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WALNUT GROVE
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8960
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2900 - Site Mitigation Program
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PR0506456
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Last modified
6/22/2020 7:55:32 AM
Creation date
6/22/2020 7:45:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506456
PE
2950
FACILITY_ID
FA0007437
FACILITY_NAME
M & K GAS STATION
STREET_NUMBER
8960
Direction
W
STREET_NAME
WALNUT GROVE
STREET_TYPE
RD
City
THORNTON
Zip
95686
APN
00115029
CURRENT_STATUS
02
SITE_LOCATION
8960 W WALNUT GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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MONITORING WELL INS'T'ALLATION REPORT <br /> CONST_RUCnON <br /> Date: --------------- <br /> Total Depth <br /> � <br /> Premise Address: <br /> Screen Length (from) (to) <br /> Filter Pack (from) (to) <br /> Well No.: Bentonite (from) (to) <br /> Grout (from) (to) <br /> Inspector: Drilling rig type <br /> Auger O.D. tove e/chri <br /> I.D. <br /> Permit No. Completion - Spipstie box (circle one) <br /> Drilling Company: <br /> casing <br /> Driller: - height <br /> '4 <br /> Consultant ffln <br /> Geologist AiOVE-GRC:UN❑ <br /> CO WP LETCN GpMpL=—MCN <br /> C�rcur�d Sirfxa <br /> SPECIAL PERMIT INFO. <br /> Qrcut <br /> Distance to sewer line <br /> Domestic well on site - (y/ n) It. <br /> if yes, location and distance - ' <br /> :Yw a-r <br /> C <br /> O <br /> SAMPL]NG �lorv,i % <br /> tocscn <br /> Holding Temperature <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> 11F <br /> It t2. <br /> SPOILS <br /> Storage Method MATERIALS/DEVEi OPMF-NT <br /> Contamination Noted - (y/ n ) Casing type <br /> Storage Location Blank ft. Screen <br /> Slot size <br /> �NG Bags <br /> GRcement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method Surge Black: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />
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