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WP0038069
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038069
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Entry Properties
Last modified
8/27/2018 10:18:42 AM
Creation date
8/27/2018 9:14:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038069
PE
4372
STREET_NUMBER
20150
Direction
S
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95304
APN
21216005
ENTERED_DATE
3/20/2018 12:00:00 AM
SITE_LOCATION
20150 S TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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AMeuangkhoth
Tags
EHD - Public
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SAN.�JUAUUIN <br />—COUNTY— <br />O�t,FOQa`p` Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Y1y1ZV!K Inspector: NAS&E" <br />Facility Address: Z-01,5-0 <br />Well Address: <br />WP# C40 S Well#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: d <br />Consultant: /tiy Z"e <br />Geologist:5,.� <br />Public Water System Onsite: ❑ Yes El No <br />Domestic Well Onsite: ❑ Yes <br />If yes, location and distance: <br />❑No <br />SAMPLING <br />Water <br />gall ons <br />Holding Temperature: <br />Cement 94 lb <br />Ba s <br />Method: <br />4Bags <br />Screening Method: <br />#Bags <br />Verified Chain of Custody: ❑ Yes <br />❑No <br />SPOILS <br />5 <br />Contamination Noted: ❑ Yes <br />❑No <br />If yes, spoils storage Location: <br />10 <br />Covered: ❑ Yes <br />❑ No <br />If yes, material: <br />2 <br />GROUTING or DESTRUCTION Total Depth: <br />15 <br />Depth to Water0c) 6 -c4 -i <br />15 <br />Grout Material: &-e e,,-/Gto" LL, I <br />3 <br />Gallons of Grout Used: <br />20 <br />❑Well Installation ❑Well Destruction <br />20 <br />❑Boring Installation [Boring Destruction <br />4 <br />METHOD USED <br />25 1 <br />❑Pressure Grout ❑Over Drill <br />25 <br />//���� <br />❑ Gravity ❑Tremie Wther: 'fkCIV <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gall ons <br />Cement 94 lb <br />Ba s <br />Thickest Thinnest <br />4Bags <br />Thickest Thinnest <br />#Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 1 <br />25 1 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 1 <br />35 1 <br />7 <br />35 <br />70 <br />7 <br />20 1 <br />40 1 <br />8 <br />40 <br />80 <br />8 <br />L! �ee C� <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />COMPLETION ❑ Stove Pipe ❑Christie Box <br />casing <br />height <br />ABOVE -GROUND CtWSTY 80X <br />COAFLETiON COMPLETION <br />Ground surface <br />grout <br />ft. <br />tt. _ <br />— o <br />slotted _ <br />secson <br />r = t-�+ P.* <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: _ <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />
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