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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARLAN
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10842
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3500 - Local Oversight Program
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PR0545272
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Last modified
1/31/2020 6:00:03 PM
Creation date
1/31/2020 4:30:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545272
PE
3528
FACILITY_ID
FA0006898
FACILITY_NAME
RAMOS OIL-FRENCH CAMP
STREET_NUMBER
10842
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
19333028
CURRENT_STATUS
02
SITE_LOCATION
10842 S HARLAN RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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MONITORING WELL iNSTAI•IATION''ORT <br /> Date:_ <br /> CONSTRUCTION <br /> Premise Address:/D$��— 5 �r.� PA Total Depth_ �6 ' 13 <br /> Well No.: 7 �� An15 Screen Length (from) (to) <br /> Filter Pack (from) (to) <br /> Inspector Bentonite (from) (cc), <br /> Grout (from) (to)�_ <br /> Permit NoJ2 ` `C" Drilling rig type <br /> Auger O.D. I.D. <br /> Drilling Company:•ii�f 0 i Completion - Stove pipe/ehristie box (cam irc(— e one)— <br /> Driller: �/l� <br /> casing. _ <br /> � <br /> Consultant l Q� height 1 � <br /> Geologist <br /> A-DOVEGACUND T <br /> CC) LEDON A: -Box <br /> SPECIAL PERMIT INFO. CCPL= cN <br /> C�xlrj Suire <br /> Distance to server line arcs <br /> Domestic well on site - 7(y/n) <br /> If yes, location and distance - IL <br /> • n ft. <br /> — a <br /> — o <br /> SAMPLING ` <br /> !: o <br /> ilorud c <br /> Holding Temperature =_ <br /> Method <br /> Screening Method = __ <br /> Tracking Sheet - (y/n ) — <br /> R. = ft. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contatninadon Noted - (y/n) u <br /> Storage Location Casing type 2- Pu <br /> Blank ft. Screen fr• <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to Water Bags sand/gravel <br /> Mix Ratios A Filter Pack type/size <br /> --Installation Method Surge Block: - ( y/ ti ) <br /> QuanthyIns Called 1AX, LR Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29. . <br />
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