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WP0041202
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041202
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Last modified
3/2/2021 2:13:26 PM
Creation date
3/2/2021 2:04:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041202
PE
4372
STREET_NUMBER
1200
STREET_NAME
HUMPHREYS
City
STOCKTON
Zip
95203-
APN
16203007
ENTERED_DATE
9/8/2020 12:00:00 AM
SITE_LOCATION
1200 HUMPHREYS
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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oPpuiN"c. <br /> SAKJOAQUIN Environmental Health Department <br /> COUNTY-- <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: I Inspector: 1 01LL CONSTRUCTION <br /> Facility Address: J' lh -' <br /> Well Address: V')00 y Total Depth: <br /> WP# r n 2-4) Z W e-I 14e Drilling Rig Type: <br /> Soil Boring#: _�f' M <br /> Drilling Company: (ZeU . Si> i,�r GQ 6yaDArcri" in 2"Annular EHD Seal Verified: 11 Yes EJ No <br /> Driller Onsite: 1 1 U 2 r Screen Length From: To: <br /> -_ <br /> Consultant: ��Lld✓ ' — �M Filter Pack From: To: <br /> Geologist: <br /> V=A ) 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 casing <br /> If yes, location and distance: height <br /> i <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMP�LEnOON <br /> Method: Gmnd Sudacs <br /> Screening Method: o�out <br /> Verified Chain of Custody: ❑ Yes ❑No �tt. <br /> tt. <br /> tt. <br /> SPOILS <br /> = e <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: sbned <br /> aeon jM = <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: SCJ!' <br /> Depth to Water: r. tt. ' — n• <br /> Grout Material: notA t)24IiQA j' MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: csa Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Size: <br /> ❑Boring Installation PBoring Destruction Bags Slot Siziz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity 'ZTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> Ratio Bas gallons Bags <br /> Thickest Thinnest ABa s Thickest Thinnest »Bags Bentonite/Cement Mix 3% Mix 3%Mix <br /> 2.5 5 1 JLA 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 1 - 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 1 25 5 25 50 5 <br /> 15 1 30 6 30 60 6 <br /> 17.5 1 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 1 F 209 464-0138 1 www.sacehd.com <br />
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