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FIELD DOCUMENTS_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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13170
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2900 - Site Mitigation Program
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PR0505432
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FIELD DOCUMENTS_FILE 1
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Last modified
1/24/2020 2:51:57 PM
Creation date
1/24/2020 2:30:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0505432
PE
2960
FACILITY_ID
FA0006779
FACILITY_NAME
DIVIDEND PROPERTY
STREET_NUMBER
13170
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
13170 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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,P )NITORING WELL INSTALLATION REPO,,,, <br /> Date: P I20 9 2- CONSTRUCTION <br /> Premise Address: J-51-70 Total Depth <br /> Screen Length (from) ';:2_0 (to) / <br /> Well No.: Filter Pack (from) -so (to) /.'?.S <br /> Bentonite (from) /;2.t5 (to) <br /> Inspector: Grout (from) V- 16 (to) e-- <br /> Drilling rig type <br /> Permit No. Auger O.D. I.D. f" <br /> Completion - tove pip clu'istie box (circle one) <br /> Drilling Company: c�$Z� (�1U.-,LtJG <br /> Driller: casing <br /> M7=6Theight <br /> _EWT <br /> Consultant <br /> Geologists -- <br /> A80VE-GRCUND CNAIST`f-8OX <br /> COAFLETION COMPLEnCN <br /> SPECIAL PERMIT INFO. Ground Sumacs <br /> Distance to sewer line VZ gout <br /> Domestic well on site - (y/ n ) <br /> ft. <br /> If yes, location and distance - <br /> • it. ft- <br /> SAMPLING sloroi = <br /> aecicn <br /> Holding TemperaturePack <br /> 4 �G <br /> Method LaU l GCT- gnvw <br /> Screening Method D V t-1 r. <br /> Tracking Sheet - & n ) _ <br /> ft. = ft. <br /> SPOILS <br /> Storage Method K✓ t�'j MATERIALS/DEVEI.OPMENT <br /> Contamination Noted - (©/ n ) <br /> Storage Location O f4 -SI11"- Casing type 40 L <br /> Blank ft. Screen 5' ft. <br /> Slot size <br /> GROUTING Bags cement 1 <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size /te <br /> Installation Method x rn c_ Surge Block: - (69/ n ) <br /> Quantity Installed Discussed with geologist: ( <br /> Type of method (�l� <br /> EH 29 29 <br /> ��`7 <br />
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