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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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EHD - Public
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0 <br /> MONITORING WELL INSTALLATION REPOn f <br /> Date: 1012,S /d 6 CONSTRUCTION <br /> Premise Address: l7 !�QyCqlyk04 Total Depth l� <br /> Screen Length (from) l/O (to) g0 <br /> Well No.: 'Z Filter Pack (from) Ito (to) <br /> Bentonite (from) (to) 8y <br /> Inspector: Grout (from) (to) O <br /> / Drilling rig type—AC <br /> C <br /> 7- 8! <br /> Permit No. 0ry a Z Auger O.D. 9 LD. <br /> Drilling Company: <br /> % E U/ <br /> Completion - Stove pipe <br /> /christie box (circle one) <br /> f 2— <br /> Driller: AA:0! Gcasn <br /> heigh <br /> Consultant � CAt!E�;�-GROUND L <br /> Geologist <br /> T <br /> LEC ON CNASTYBOX <br /> CGMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line 50 grcurt <br /> Domestic well on site - n ) ft <br /> If yes, location and distance - ? <br /> 9°h. <br /> C <br /> 0 <br /> SAMPLING :la ted <br /> tac5on <br /> Holding Temperature <br /> Method <br /> Screening Method r` <br /> Tracking Sheet - (y/ n ) <br /> SPOILS ',/ <br /> Storage Method��° �T � MATERIALS/9EVELOPMENT <br /> Contamination Noted - (y/_n,) p <br /> Storage Location--� kea Casing type 2 T �� <br /> Blank_ Q ft. Screen <br /> Slot size 610 <br /> GROUTING Bags cement // / <br /> Buckets bentonite / ' 3 <br /> Depth to water Bags sand/gravel 7'12 <br /> Mix Ratios / ter^ 9r/-2L r f f Filter Pack type/size /� <br /> Installation Methods - 0&4A d&,CA- Surge Block: - y n) <br /> Quantity Installed /+"/ Discussed with geologist: - y n ) <br /> Type of method <br /> EH 29 29 <br /> 105510 6 ��Z <br />
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