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WP0038783
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038783
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Entry Properties
Last modified
9/25/2018 3:03:04 PM
Creation date
9/25/2018 3:01:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038783
PE
4374
STREET_NUMBER
8477
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00705010
ENTERED_DATE
9/17/2018 12:00:00 AM
SITE_LOCATION
8477 E PELTIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SQN `JOQQUIN Environmental Health Department <br />—COUNTY— <br />Greatness yrorrs Dere. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 9 Inspector: <br />Facility Address:- 7 -1 C Pkq-h',,,-i[ot � <br />Well Address: <br />WP# ro-Iff7R3 Well#: <br />Soil Boring#: <br />Drilling Company: Pjm <br />Driller Onsite: MI W. - <br />Consultant: <br />Geologist: <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />rnnlCTDI IrTlnnl <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />From: <br />Filter Pack <br />From: <br />Bentonite <br />From: <br />Grout <br />From: <br />❑ Yes ❑No COMPLETION ❑ Stove Pipe <br />❑ Yes ❑ N o <br />❑ Yes El No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />GROUTING or DESTRUCTION Total Depth: 1 -He <br />Depth to Water: Icy <br />Grout Material: /J - 3 S'. -- <br />Gallons of Grout Used: &00 6 V c� <br />❑Well Installation M ell Destruction <br />❑Boring Installation ❑Boring Destruction <br />nncrunn i 1CM <br />❑Pressure Grout <br />El�Over Drill <br />El Gravity L?Tremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />kBags <br />Thickest Thinnest <br />tJBags <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 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <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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