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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VON SOSTEN
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16555
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3500 - Local Oversight Program
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PR0545795
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Last modified
6/15/2020 2:51:48 PM
Creation date
6/15/2020 2:40:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545795
PE
3528
FACILITY_ID
FA0002952
FACILITY_NAME
LAMMERSVILLE SCHOOL
STREET_NUMBER
16555
STREET_NAME
VON SOSTEN
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
20914009
CURRENT_STATUS
02
SITE_LOCATION
16555 VON SOSTEN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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'ONITOPJNG WELL INSTALLATION REPO' <br /> CONSTRUCI30N <br /> Date: <br /> Premise Address: Total Depth <br /> Screen Length (from) (to)— — <br /> WeII No.: Filter Pack (from) (to)� <br /> Bentoake (from)_ (to) <br /> Grout (from) _ —(to) <br /> Inspector. _ <br /> Drilling rig We <br /> Permit No. <br /> Auger O.D. I.D. <br /> Completion - Stove pipeJch.ristie box (circle one <br /> Drilling Company: <br /> cas,nq <br /> DrilIer: + 7�7 he_ghe <br /> Y � 1 <br /> Consultant r, <br /> Geologist <br /> A80VE-GFiG`l.fNi] 013ifS1`C-3OX <br /> CJt�L°T;CN CCb{PLC_MCN <br /> SPECIAL PERT INFO. Saga <br /> MI <br /> grccst <br /> Distance to sewer line <br /> Domestic well on site - ( y/ n ) <br /> If yes, location and distance - - <br /> ft. . ... — <br /> r <br /> C <br /> 0 <br /> SAMPLING siora� = c <br /> sac;cn '� <br /> Holding Temperature — gnVO4 <br /> Pack <br /> Method <br /> Screening Method <br /> Tracking Sheet - ( y/ n ) <br /> SPOILS <br /> Storage Method MATEWALSMEVEI.OPMENT <br /> Contamination Noted - (y/ n ) <br /> Storage Location Casing�e <br /> Blank ft, Screen ft. <br /> Slotsize <br /> GROU77NG Bags cement <br /> Buckets bentonite <br /> Depth to waren Bags sand/gravel <br /> Mix Ratios Filter Pack Me/size <br /> installation Method 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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