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WP0040848
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040848
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Last modified
6/25/2020 11:30:49 AM
Creation date
6/25/2020 10:21:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040848
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
07
P_DISTRICT
003
QC Status
Approved
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TSok
Tags
EHD - Public
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SAN -JOAQUIN Environmental Health Department <br /> COUNTY __... <br /> Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: 6g k.*-'e d CONSTRUCTION <br /> Facility Address: &5--6 Pelf / <br /> Well Address: Total Depth: �6 C1 1 <br /> WP# An LA U LI 8 Well#: Drilling Rig Type: <br /> Soil Boring#: C197 f- 3 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: uQNli <br /> Screen Length From: To: <br /> Consultant: Ml"4' <br /> �'Ad Ho Filter Pack From: To: <br /> Geologist:�Dvini IL <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes []No —tet-- casing <br /> If yes, location and distance: 37 <br /> T height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: coMaLErtON comptEnON <br /> Method: Ground Suiac+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No —` n' <br /> n. <br /> it. <br /> SPOILS <br /> Contamination Noted: ❑ Yes 1:1 No <br /> If yes,spoils storage Location: atonad yr <br /> aac-jon '— <br /> Covered: ❑ Yes El No = g-v*+Pack <br /> If yes, material: <br /> i <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: /I/ n• .� n' <br /> Grout Material: (A F' <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation_qboring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity 4Tremie ❑Other: Type of Method: <br /> Waterent 471b Water Cement 94 lb <br /> Cem <br /> gal lons Bas gall ons Bags <br /> Thickest Thinnest uBags Thickest Thinnest NBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 25 s0 5 <br /> 15 30 6 30 60 6 <br /> 17.S 35 7 35 70 7 <br /> 20 40 1 8 40 80 8 <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.socehd.com <br />
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