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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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SAN JOAQUIN j —COUNTY Environmental Health Department <br /> ` <br /> Greatness grows her< <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: `y�) Z Inspecto : C "�S CONSTRUCTION <br /> Facility Address: <br /> Well Address: Total Depth: <br /> WP# 01 �6(_7 Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: ��� (( C i x L1��1 i0� Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: _ Cc, r�c_ Filter Pack From: To: <br /> Geologist: {i( C Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes 11 No casing <br /> If yes, location and distance: IT height <br /> T,F6 —tw' <br /> SAMPLING AllOVE-GROUND <br /> Holding Temperature: 001APLET1ON COMPLE71CCN <br /> Method: Ground Sulacs <br /> Screening Method: ar«rt <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes []No <br /> If yes, spoils storage Location: Slott <br /> a 'cn _ 3 <br /> Covered: ❑ Yes ❑No = �� <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _ <br /> Depth to Water:�� '1.�� '(� ft• <br /> tt. <br /> Grout Material: k4-CA cu('d\A 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 ❑Boring Destruction Bags iz 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 4:Bags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 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 1 35 70 7 <br /> 20 40 1 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 www.socehd.com <br />
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