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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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V
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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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MONITORING WELL INSTALLATION REPO• <br /> Date: ( /�/Ti CONSTRUCTION <br /> Premise Address: Total Depth Zy <br /> Screen Length (from) 9 (to) ?G/ <br /> Well No.: l/ / ' ', Filter Pack (from) Zai 9 (to)� <br /> Bentonite (from) 7.7 6 (to) /gg <br /> Inspector: c� Grout (from) (to) <br /> Drilling rig type s4c,> /uv, <br /> Permit No. Auger O.D. LD. <br /> Drilling Company:. <br /> / Completion hristie box (circle one) <br /> /�ilO�-T�/�.v- tope-p' <br /> Driller: casing <br /> J� height <br /> Consultant��p�r4� <br /> Geologist <br /> ABOVEloRCUND CNRISTY 30X <br /> COMPLETION COMPLETICN <br /> SPECIAL PERMIT INFO. Ground Surlacrr <br /> Distance to sewer line stout <br /> Domestic well on site - (y/ n ) <br /> If yes, location and distance - <br /> ft ft. <br /> yi = <br /> = m <br /> SAMPLING dorad = B <br /> aacicn _ <br /> Holding Temperature = trawl Pads <br /> Method = <br /> Screening Method <br /> Tracking Sheet - (y/ n ) _ <br /> �r It. <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/ n ) <br /> Storage Location Casing type 2—" ,Ails <br /> Blank ft. ScreenZft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios Filter Pack type/size <br /> Installation Method tillJ2v Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - (y/ n ) <br /> Type of method <br /> EH 29 29 <br />
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