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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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TORING WELL INSTALLATION REPO <br /> Date: l� 3/!U .� //2— 1 5- CONSTRUCTION / <br /> Premise Address: lT C S� I/ /" Total Depth 6� <br /> Screen Length (from)_ (to) C <br /> Well No.: 8 Filter Pack (from) 10 (to) <br /> Bentonite (from) (to) <br /> Inspector: Grout (from) , (to) <br /> Drilling rig type <br /> Permit No. o 6/(!J� Q Auger O.D. I.D. <br /> jCo 'on - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> ✓ LG!/ <br /> Driller: 'lam �� heicas nt�ei tConsultant <br /> Geologist VE-GROUND <br /> COf�LETION C44A1S11 80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Grund S�e� <br /> N ^ d <br /> lgrout <br /> Distance to sewer ine jy (�R <br /> Domestic well on site - y/ n ) L�� ��� ft. <br /> If yes, location and dist ce - 7 roG Leu n tt. <br /> = m <br /> - m <br /> SAMPLING slotted :V = <br /> Holding Temperature �/ _ - .mom Pad, <br /> Method = <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) <br /> SPOILS ! ,( <br /> Storage Method """' MATERIALS/DEVELOPMENT <br /> Contamination N ,oted - (y n L(/ �`/� <br /> Storage Location Casing type <br /> Blank ' oU ft. Screen � fr• <br /> Slot size 0720 <br /> GROUTING Bags cement IRR <br /> /4 meets bentonite O » p k <br /> Depth to water �7 rI Bags sand/gravel 7W <br /> PT <br /> Mix Ratios 16 y !Y Filter Pack type/size <br /> Installation Method Surge Block: - (y n <br /> Quantity Installed ! ft} / Discussed with geo ogtst: - (y 0 <br /> Type of method <br /> EH 29 29 <br /> t3a1 1� � <br />
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