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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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2420
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3500 - Local Oversight Program
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PR0545209
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Last modified
1/27/2020 5:07:37 PM
Creation date
1/27/2020 4:24:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545209
PE
3528
FACILITY_ID
FA0003963
FACILITY_NAME
TRACY76
STREET_NUMBER
2420
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
Tracy
Zip
95377
APN
23802006
CURRENT_STATUS
02
SITE_LOCATION
2420 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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JNITORING WELL INSTALLATION REPO.,.,, <br /> Date: CA CONSTRUCTION <br /> , <br /> Premise Address: cc..- � -�--�` Total Depth <br /> Screen Length (from) 7 (to) 7 <br /> Well No.; � `' Filter Pack (from) (to) <br /> Bentonite (from) _(to)� <br /> lnspeceor. . ��...� r'1 Grout (from) 4 (to) - �- <br /> Drilling rig type <br /> _ /777777 <br /> Permit No. C 1 Auger O.D. 1. <br /> Completion - Stove pipe/ in 'e box circle one) <br /> Drilling Company: C,�Ai; �- <br /> Driller: casing <br /> height <br /> Consultant --I", VYA <br /> c Ird17 <br /> Geologist c . .. ._ <br /> ABOVE-GRCUND CNRZ1'Y48UX <br /> cONFLETI N caapurncN <br /> SPECIAL PERMIT INFO. Grourd Surface <br /> Distance to sewer line <br /> Domestic well on site - ( y- ( y/ n )n ) <br /> If yes, location and distancev <br /> ft. ft. <br /> _ 7 <br /> - N <br /> iO <br /> SAMPLING — <br /> tlorn� <br /> aat'acn � <br /> Holding Temperature -= gm�w F <br /> ack <br /> Method _ <br /> Screening Method <br /> Tracking Sheet - (y/ n ) <br /> SPOILS <br /> Storage Method 0-f\ MATERIALS/DEVELOPMENT <br /> Contamination Noted - / n ) i E <br /> Storage Location 2 Casing type <br /> Blank--:1—ft. Screen 1 ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite ,)- <br /> Depth to water_ _ Bags sand/graveI <br /> Mix Ratios Filter Pack type/size V <br /> Installation Method Surge Block: - ( y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />
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