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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VIA NICOLO
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17950
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2900 - Site Mitigation Program
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PR0516772
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Last modified
6/1/2020 12:40:03 PM
Creation date
6/1/2020 12:21:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0516772
PE
2965
FACILITY_ID
FA0012793
FACILITY_NAME
MUSCO OLIVE LAND APP/TITLE 27
STREET_NUMBER
17950
Direction
W
STREET_NAME
VIA NICOLO
STREET_TYPE
RD
City
TRACY
Zip
95377
APN
20911032
CURRENT_STATUS
01
SITE_LOCATION
17950 W VIA NICOLO RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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OONITORING WELL INSTALLATION REPO <br /> Date:_ 17 9,oaQ CONSTRUCTION �[ <br /> Premise Address: / Total Depth ! s <br /> Well No.: 3 �/ Screen Length (from) (to)�� <br /> Filter Pack (from) .S (to) <br /> Inspector: GroutBento (from) <br /> (from) (to) 2 <br /> (from) (to) <br /> Permit No. <br /> 473 Drilling rig type Pl <br /> 7 J Auger O.D. S I.D. <br /> Drilling Company: e)Completion - Stove pipe/christie box (circle ono— <br /> Driller: <br /> n <br /> Driller: t y nasi g <br /> heig t <br /> Consultant- 4-tv�! <br /> Geologist� <br /> v U AE&E-GROUND <br /> COMPLETION CHRZTY-BOX <br /> SPECIAL PERMIT INFO. ,•.o / Ground Surface}SurfaceCOMPLETION <br /> Distance to sewer line grout <br /> Domestic well on site - (yn Z <br /> If yes, location and distancen• <br /> Win. n. <br /> y <br /> = m <br /> — e <br /> SAMPLING <br /> slotted <br /> � <br /> &&cion <br /> Holding Temperature <br /> Method = gravel Pack <br /> Screening Method x, _ <br /> Tracking Sheet - (y/ n ) ``TT//ll22 — .. <br /> fin. n. <br /> SPOILS <br /> Storage Method w-a- 4AA- MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ n ) Z VC <br /> Storage Location Casing type <br /> Blank Z2 ft. Screen 15 ft. <br /> Slot size '016 1, <br /> GROUTING Bags cement C n <br /> �/ 9 i Buckets bentonite o� 230 " <br /> Depth to water " 0 Bags sand/gravel <br /> Mix Ratios_ TCALAO + gke* Filter Pack type/size /L <br /> Installation Metho &'f~—oww.i, s�-o+e_J Surge Block: - (y/n ) <br /> Quantity Installed 90� Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />
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