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4200/4300 - Liquid Waste/Water Well Permits
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WP0040470
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Entry Properties
Last modified
6/29/2020 1:56:06 PM
Creation date
6/29/2020 1:49:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040470
PE
4372
STREET_NUMBER
121
Direction
N
STREET_NAME
GUILD
STREET_TYPE
AVE
City
LODI
Zip
95240-
APN
04932012
ENTERED_DATE
1/22/2020 12:00:00 AM
SITE_LOCATION
121 N GUILD AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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S A N J 0 A 0 U I N <br /> couNTY— Environmental Health Department <br /> - <br /> \`_!s'j Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: g 172 Inspector: K. SOetern CONSTRUCTION <br /> Facility Address:UI E t19 N. &,alei Ave- <br /> Well Address: Total Depth: <br /> WP#_p(_)4041O Well#: Drilling Rig Type: <br /> Soil Boring#:BI,lb-165, e4o „ <br /> Drilling Company: wet c) ander5oc) /7err'accn Min 2 Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: IZoher*- <br /> Screen Length From: To: <br /> Consultant:N;ek _ <br /> Filter Pack From: To: <br /> Geologist: Y-Qn' Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING xsovE-GROUND <br /> Holding Temperature: cot"g' TiONmoa <br /> Method: Ground SWaca <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> ft. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No _ <br /> If yes'spoils storage Location: <br /> sfottad <br /> a+c fQn �= <br /> Covered: ❑ Yes ❑No _ <br /> If yes, material: = <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: ane a5-lock <br /> Grout Material: tiPak Cernenj- <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Size: <br /> ❑Boring Installation I)IBoring Destruction Bags Slot Siziz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Raillf ons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags 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 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sicehd.com <br />
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