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WP0041591
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041591
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Last modified
3/5/2021 12:51:51 PM
Creation date
3/5/2021 12:35:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041591
PE
4372
STREET_NUMBER
3009
STREET_NAME
POCK
STREET_TYPE
LN
City
STOCKTON
Zip
95205-
APN
17912011
ENTERED_DATE
1/6/2021 12:00:00 AM
SITE_LOCATION
3009 POCK LN
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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z <br /> SAN.-JOAQUIN Environmental Health Department <br /> too --COUNTY <br /> ,',IF�' Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Z1 Inspector: t.'' / CONSTRUCTION <br /> Facility Address: v <br /> Well Address: Total Depth: <br /> WP# 0C) Well#: Drilling Rig Type: <br /> Soil Boring#: ; Min 2"Annular EHD Seal Verified: 11 Yes El No <br /> Drilling Company: l ,c f f'117G%� <br /> Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: f� CC; i T t-\ C Filter Pack From: To: <br /> Geologist: 11 _ 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: I T height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWPLETION cCar+PtF O�N <br /> Method: GmneSurface T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No —`---n' <br /> ft. <br /> tt. <br /> SPOILS a <br /> a <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: abnad <br /> axion — B <br /> Covered: ❑ Yes ❑No _ I <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: `1 2 c <br /> Depth to Water: <br /> Grout Material: �� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction , 1\ Blank Feet Screen Feet <br /> J} <br /> El Boring Installation n-Boring Destruction Slot Size: <br /> 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 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest aBags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 3% Mix <br /> 2.s s 7 1 ✓ 5 10 1 Bentonfte 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 L 25 5 25 50 5 <br /> 15 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.socehd.com <br />
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