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WP0040847
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040847
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Last modified
6/25/2020 12:08:31 PM
Creation date
6/25/2020 10:20:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040847
PE
4372
STREET_NUMBER
850
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95231-
APN
19802001
ENTERED_DATE
5/22/2020 12:00:00 AM
SITE_LOCATION
850 ROTH RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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TSok
Tags
EHD - Public
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opc i in�. <br /> % ; �z SAN.JOAQUIN <br /> r.� Environmental Health Department <br /> ` ..�' ! —COUNTY <br /> Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: b 2 2 V Inspector: J CONSTRUCTION <br /> Facility Address: 950 4*41) <br /> Well Address: Total Depth: ��2v ��� ��l� <br /> WP# coti DS`I Well#: Drilling Rig Type: r 50-� 8 Hsh <br /> Soil Boring#: A1 3 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: y (� <br /> �— Screen Length From: To: <br /> Driller Onsite: "& <br /> 1 <br /> Consultant: M�'�a Aga b r-, Filter Pack From: To: <br /> 1df <br /> Geologist: 'n 'L Bentonite From: To: <br /> g �� <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLS X:)N COMP�_tEnoN <br /> Method: Ground&x1aca <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No �fl' <br /> tt. <br /> ft. <br /> SPOILS y <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: abed _ B <br /> sac <br /> on <br /> Covered: ❑ Yes ❑No <br /> If yes, material: 2 <br /> GROUTING or DESTRUCTION Total Depth:.JV IJ / 20 =_ <br /> Depth to Water: <br /> Grout Material: t N MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation�Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity Tremie ❑Other: Type of Method: <br /> Water rcement 471b Water me <br /> allons Bas allons Bags <br /> Thickest Thinnest s Thickest Thinnest BentonitelCement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 <br /> 10 20 4 20 40 <br /> 12.5 25 5 25 50 <br /> 15 30 6 30 60 <br /> 17.5 35 7 35 7020 40 e 'n40 ao <br /> 30 (,,,,e,� W/ ?)jD�fiA U(•Glk.✓ � &%-D- 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />
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