WORK PLANS - Laserfiche WebLink

Home Browse Search

S A N . J O A Q U I N Environmental Health Department COU NTY Greatness grows here. SITE MITIGATION WELL & BORING PERMIT APPLICATION NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED 24 Hours Advance Notice Required For All Inspections CALL (209) 953-7697 For INSPECTIONS Application is hereby made to San Joaquin County for a permit to construct and/or install the work described. This application is made in compliance with San Joaquin County Development Title,Chapter 9-1115.3,and the San Joaquin County Well Standards. Job Address BNSF Stockton Intermodal Facility,Arch Rd City/State/Zip Stockton,CA 95215 Phone 209-460-6476 Cross Street Jack Tone Road APN 18117007 Property Owner* BNSF Railway Company Phone 913-551-4591 Address 11925 W.Thompson Ranch Rd City/State/Zip-El Mirage,AZ 85335 C-57 Contractor Cascade Drilling License# 1058336 Phone 510-478-0858 Address 3459 Collins Ave City/State/Zip Richmond CA 94806 Consultant/Sub-Contractor TRC(Consultant) License# 409606 Phone 925-494-4385 Address 1850 Gateway Boulevard,Suite 1000 City/State/Zip Concord,CA 94520 CONSTRUCTION WORK TO BE PERFORMED:'Note: Offsite Borings/Wells Require Access Agreements or Encroachment Permits TYPE OF WELL(BORING NUMBER INSTALLATION TYPE CONSTRUCTION SPECIFICATIONS ❑ MONITORING ❑ HOLLOW STEM BORING DEPTH 1.5 ft-15 ft ❑BOLTED TRAFFIC BOX ❑STOVE PIPE ❑ EXTRACTION(Vapor/Water) ❑ HAMMER/DRIVEN DIA.OF BOREHOLE 3 inches ❑MULTIPLE CASINGS❑MULTI-LEVEL WELL CASING DIA ❑ SOIL VAPOR PROBE ❑ MUD ROTARY CASING THICKNESS TYPE OF CASING: ❑STEEL ❑PVC ❑ OTHER ® SOIL BORING 6 D( PT) IS] PUSH POINT(GP/CPT) CONDUCTOR CASING ❑Yes ❑No Boring Dia: Casing Dia: Casing Depth: ❑ INJECTION(Air Soarae,Ozone) 7 El HAND AUGER GROUT SEAL DEPTH TREMIE TYPE TO BE USED: ❑AUGERS ❑HOSE ❑PIPE ❑ OTHER ❑ OTHER: GROUT SEAL PUMPED? ❑Yes ❑No (Note:Maximum Freefall Depth is 30 Ft) WELL/SOIL BORING IDs B-1 through B-13 GROUT SPECIFICATIONS Borings will be grouted upon completion. DESTRUCTION WORK TO BE PERFORMED: DESTRUCTION METHOD: (CHECK ALL THAT APPLY) #WELLS TO BE DESTROYED ❑OVER-BORE DIAMETER of inches to depth of feet WELL IDs ❑PRESSURE GROUT To depth of feet below surface GROUT SPECIFICATIONS ❑EXPLOSIVES From to feet below surface TREMIE TYPE TO BE USED ❑AUGERS [IHOSE [IPIPE ❑MUSHROOM CAP ❑3 feet below surface or feet below surface if>3 feet COMMENTS:Complete 13 soil borings to depths of 1.5 feet(6 locations),6 feet(1 location), 10 feet(3 locations), 15 feet(2 locations),and 25 feet(1 location).Soil samples will be collected and borings will be grouted upon completion. Please EXPEDITE permit processing --will pay the 1.5x fee rate. I hereby certify that I am authorized to complete this application and that the work will be done in accordance with San Joaquin County Ordinance Codes and Standards,and all other applicable California laws. Signed 2 �a , Title/Company. Project Geologist/TRC Print Name Laura Tait Date 3/15/2023 DEPARTMENT USE ONLY Application Accepted By: Date Issued: Grout Inspection By/Dates: Destruction Inspection By/Dates: Facilit /Site Information FA Name FA Address FA# PR# FA PE WP Reviewed By Work Plan Date ❑C-57 ❑C-57 Authorization for Other to Sign Permit ❑Worker's Comp ❑Worker's Comp Waiver ❑Encroachment Permit ❑Access Agreement ❑Lead Agency Approval ❑MFR COMMENTS/CONDITIONS: WP TYPE PE SC FEE INFO AMT REMITTED CHECK# RECV'D BY DATE WELL PERMIT# INVOICE# Permit $152 x 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com EHD 29-01 04-04-07 Site Mitigation Well Permit Application