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4200/4300 - Liquid Waste/Water Well Permits
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WP0041062
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Last modified
11/17/2021 1:48:53 PM
Creation date
10/29/2020 4:43:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041062
PE
4372
STREET_NUMBER
1121
STREET_NAME
MCCLOY
STREET_TYPE
AVE
City
STOCKTON
Zip
95203-
APN
16203007
ENTERED_DATE
8/6/2020 12:00:00 AM
SITE_LOCATION
1121 MCCLOY AVE
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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, SANvJOAQUIN Environmental Health Department <br /> / —COU NTY— <br /> � tiP` Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> e� <br /> Date: 0 ?� p Inspector: `*�4W,s[o CONSTRUCTION <br /> Facility Address: <br /> Well Address: ((�,j JAX (loc Avq Total Depth: / <br /> WP#�Z�(p(, Well#: Drilling Rig Type: .�,/ <br /> Soil Boring#: IDSA LS 4 (SSA 23 146A ''( Z Min 2" Annular EHD Seal Verified: El Yes []NoDrilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: alr.. ¢ � �cl�•:CL. ��� <br /> Filter Pack From: To: <br /> Geologist: roo(c� /11�(./,'n I�ro�jcGl A' fr 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 ABOVE-GROUND <br /> Holding Temperature: COk FLEMN COMPLETION <br /> Method: Ground Surface <br /> Screening Method: ar�— <br /> Verified Chain of Custody: ❑ Yes ❑No ft' <br /> it. <br /> it. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No " <br /> If yes, spoils storage Location: abed <br /> l S s�cdon j <br /> Covered: ❑ Yes ❑No �� i 3 _ gravel Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: x ID ` fL V n' <br /> Grout Material: Md (.0 w,\ 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 XBoring Destruction Bags of 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 47 lb Water Cement 941b <br /> allons Bas stallons Bags <br /> Thickest Thinnest uBags Thickest Thinnest aBags 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 2Bentoniie 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 /> j « i 10/16/2017 <br /> 1868 E. Hazelton Avenue i Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />
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