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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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ROTH
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850
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2900 - Site Mitigation Program
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PR0506824
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Last modified
4/7/2020 3:26:58 PM
Creation date
4/7/2020 2:23:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506824
PE
2960
FACILITY_ID
FA0007648
FACILITY_NAME
DDRW - SHARPES
STREET_NUMBER
850
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19802001
CURRENT_STATUS
01
SITE_LOCATION
850 E ROTH RD BLDG S-108
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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MONITORING WELL INSTALLATION REF KT <br /> Date: I J I I� 1 CONSTRUCTION <br /> Premise Address: ED/ eWl, Pei 1,a,-74"n- Total Depth <br /> 1 VV Screen Length (from) (to) <br /> / � Filter Pack (from) Ctb) <br /> Well No.: e SV Benronite (from) Cto) <br /> Inspector. Grour (from) (to) <br /> Loo Z� Dulling rig type <br /> Permit No. oo -7 Auger O.D. L.D.L <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling CoM. Z <br /> r. J ccastag <br /> Drille <br /> he <br /> Consultant <br /> GeologistR6 /18CYE.;ACUNO ` <br /> �f.P��T'ON q-RtST`!-30X <br /> COMP1=iiCN <br /> SPECIAL PERMIT INFO. T-- <br /> i <br /> n� <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n ) t <br /> If yes, location and distance - <br /> 73O <br /> O <br /> O <br /> SAMPLING sirbctcn <br /> Holding Temperature <br /> Method <br /> Screening Method = <br /> Tracking Sheet • C y/ n) <br /> ;L ♦ — ♦ _ tt <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ a) Casing type <br /> Storage Location Blank <br /> 6ccreen _ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> y( ( Bags sand/grave! <br /> Depth Co water Filter Pack type =e <br /> Mix Ratios n"t° Ce 7 <br /> Installation Method Surge Block: - (y/ ) <br /> Quantity Installed Discussed with geologist - C y/ a) <br /> Type of method <br /> EH 29 29 <br />
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