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COMPLIANCE INFO_FILE 1
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0523599
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COMPLIANCE INFO_FILE 1
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Last modified
2/12/2020 5:23:18 PM
Creation date
2/12/2020 3:01:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
FileName_PostFix
FILE 1
RECORD_ID
PR0523599
PE
2960
FACILITY_ID
FA0015929
FACILITY_NAME
PORT OF STOCKTON BLDG #16
STREET_NUMBER
305
STREET_NAME
FYFFE
STREET_TYPE
AVE
City
STOCKTON
Zip
95201
CURRENT_STATUS
01
SITE_LOCATION
305 FYFFE AVE BLDG 16
QC Status
Approved
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EHD - Public
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MONITORING WELL 1NSTAI1.ATI0N REPORT <br /> CONSTRUCTION <br /> Date: <br /> Total Dcpth ) <br /> Premise Add (to <br /> ress: Screen Length (from) EO) <br /> D _ Filter Pack (crop) (to) <br /> Well No.: '� Bentonite (from) (to) <br /> . Grout (from) ' <br /> Inspector: �� ' ^Y"\ Drilling rig type <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/cluiscie box (cLrcle one) <br /> Drilling Company <br /> casing <br /> Driller': –�F height , <br /> -a,Consultant S 1 '�` '�' <br /> Geologist A�;`f-GRCUND Ct- ZiY-aoX <br /> Ca L._MON Cv{ ?Li1CN <br /> C-rx:r�S�.zf xs <br /> SPECIAL PcRMIT INFO. <br /> Distance to sewer line ____ ff. <br /> Domestic well on site = (y/ n) ft. <br /> If yes, location and distance - �ft• _ <br /> _ _ o <br /> _ — a <br /> ilar.?d <br /> Sr1MPUNCT 12- iCrl - <br /> Holding Temperature <br /> Method = <br /> Screenino Method : <br /> Tracking Shcet - (y/ n) <br /> SPOILS <br /> MA-t g�q /pEVELOPMENT <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing type f <br /> Storage Location Blank ft Screen <br /> Slot size <br /> Bags cement <br /> GROUCING Buckets bentonite <br /> Bags sand/gravcl <br /> Depth to water Filter Pack type/size <br /> Mix Ratios Surge Block: - (y/n) <br /> installation Method Discussed with geologist: - (y/n <br /> Quantity Installed Type of ncdiod <br /> EH 29 29• , <br />
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