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WP0041987
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041987
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Entry Properties
Last modified
7/9/2021 1:14:50 PM
Creation date
7/9/2021 11:28:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041987
PE
4372
STREET_NUMBER
403
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336-
APN
22104034
ENTERED_DATE
5/3/2021 12:00:00 AM
SITE_LOCATION
403 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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SAN JOAQUIN <br />fl ---COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date:6/3/g0X1 Inspectorr:DaiCk A • CONSTRUCTION <br />Facility Address: g10.3 PA oc. <br />f <br />-4 / vci • <br />Well Address: <br />wP# 0 0 Li 98 4- <br />Soil Boring#: 6 <br />Drilling Company: Kc&tUsi I ,43-SPC/NeCk-.3 <br />Driller Onsite: <br />Consultant: iiC.1 -0,_da417 °C-16:4-3 <br />Geologist: 6 c- <br />Well#: <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes EINo <br />Screen Length From: To: <br />Filter Pack <br /> <br />From: To: <br />Bentonite From: To: <br />Grout From: To: <br />Public Water System Onsite: Yes [iNo COMPLETION El Stove Pipe EChristie Box <br /> <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 />z5s <br />61: so <br />EIN0 tSz 2-0' <br />to <br />Domestic Well Onsite: E Yes El No <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 />Covered: <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Grout Material: <br />Gallons of Grout Used: ^-)4.19 <br /> <br />Depth to Water: <br />Aie6k-t- <br />9 <br />LII Well Installation El Well Destruction <br />111 Boring Installatio Boring Destruction <br />METHOD USED <br />OPressure Grout ElOver Drill <br />44aravity TAremie <br />Water <br />gallons <br />Ceme 4-7Ib <br />Ba <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest # Bags <br />2.5 5 1 s 10 1 <br />5 10 2 10 20 2 <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 />q <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 />I kr, H3 ky <br />ie sa-ociy $00 u p >n AAA_ <br />tAle°1- '35 -C4- 04 -./7.efltie wiz,rto_ y ro <br />.ECk <br />j <br /> <br />ic-rr--071- ncf. f4/1 <br />Yes <br />LI Yes ON° <br />ON° <br />III Yes <br />casing <br />height <br />ABC.- VE-GROLIND <br />COMPLETION <br /> <br />CHRISTY-50X <br />COMPLETION <br />_ft <br />slotted <br />sects n <br />ft <br />Stockton, California 95205 I T 209 4.8-3420 1 F 209 464-0138 I www.sjcehd.com Kac[s SA-4 6.0,1 ) C.0//A-M1 <br />1868 E. Hazelton Avenue
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