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WP0041901
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041901
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Last modified
6/8/2021 9:45:11 AM
Creation date
6/8/2021 9:39:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
File Section
COMPLIANCE INFO
RECORD_ID
WP0041901
PE
4372
STREET_NUMBER
6545
STREET_NAME
EMBARCADERO
STREET_TYPE
DR
City
STOCKTON
Zip
95219-
APN
09827022
ENTERED_DATE
4/5/2021 12:00:00 AM
SITE_LOCATION
6545 EMBARCADERO DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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tt <br />casing <br />height <br />ABOVE-GROUND <br />COMPLETION Ci-tFUSTY-BOX <br />COMPLETION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: CI Yes ON° <br />To: <br />To: <br />To: <br />To: <br />CI Stove Pipe li1Christie Box <br />Ground Surface <br />grout <br />_ft. <br />slotted <br />seclon <br />gravel pack <br />tt <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />From: <br />From: <br />From: <br />From: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br /> .ke4dje . <br />t4c,i3cr <br />(7,i7- SAN JOAQUIN rtatlic0) COUNTY — <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Environmental Health Department <br />Public Water System Onsite: <br /> El Yes 111N0 <br />Domestic Well Onsite: Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Depth to Water: <br />Grout Material: <br />Gallons of Grout Used: <br />OWell Installation OWell Destruction <br />El Boring Installation ?Boring Destruction <br />METHOD USED <br />El Pressure Grout DOver Drill <br />111 Gravity XTremie Other: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest 4 Bags Thickest Thinnest # Bags <br />2.5 5 1 L." 5 10 1 <br />5 10 2 L,./ 10 20 2 <br />7.5 15 3 t / 15 30 3 <br />10 20 4 k,' 20 40 4 <br />12.5 25 , 5 Vi 25 50 5 <br />15 30 L/ t 6 / 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />CONSTRUCTION <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16/2017 <br />Inj_pector: Date: <br />Facility Ad res <br />Well Address: <br />WP# Well#: <br />GROUTING or DESTRU I N Total Depth: <br />LA 5-134 <br />Covered: <br />If yes, material: <br />LIl Yes EINo <br />LI Yes EINo <br />Yes EINo <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com
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