WORK PLANS - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN Environmental Health Department W COUNTY atG�Jrr �[Kpr• VrCuair r:s� yi c:r r;r;.:'. SITE MITIGATION WELL & BORING PERMIT APPLICATION For Wells and Borings Used for Contaminant Investigations and Remedlatlon NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED 48 Hours Advance Notice Required For All Inspections Application is hereby made to San Joaquin County for a permit to oonstnx:t andlor Install the work described. This application Is made In compliance with San Joaquin County Development Ti0s,Chapter 9-1115.3,and the San Joaquin Candy Well Standards. 2700 West Washington Street Stockton,CA 95203 Job Address Clty/Stabflip Phone Cron Street Navy Drive D�.1r APN 1.45-030-11 Property owner- Port of Stockton _ phone (209)948-0246 Address 2201 West Washington Street CKy/Staterzip Stockton,CA 95201 C-87 Contractor WOOdward Drilling Company Inc Lic nma 710079 phone (707)374-4300 Address 550 River Road CKy/stat§Mp Rio Vista,CA 94571 ConsuttantfSub-Contractor Orion Environmental Ln photo (510)525-2180 Adder 2332 5th Street.. Suite B CKy/statemp Berkeley,CA 94710 CONSTRUCTION WORK TO BE PERFORMED:'Note Offsile BoringsIVVells Require Access Agreements or Encroacivnent Permits TYPE OF WELUBORING NUMBER INSTALLATION TYPE CONSTRUCTION SPECIFICATIONS ❑ MONITORING ❑ HOLLOW STEM BORING DEPTH ❑BOLTED TRAFFIC BOX ❑STOVE PPE ❑ EXTRACTION(VapaMWswr) ❑ HAAIMERADRNEN DIA,OF BOREHOLE ❑MULTIPLE CASINGS❑MULTI-LEVEL WELL CASING DLA ❑ SOIL VAPOR PROBE ❑ MUD ROTARY CASING THICKNESS TYPE OF CASING ❑STEEL ❑PVC ❑ OTHER ❑ SOIL BORING ❑ PUSH POINT(GP:CPT) ONDUCTOR CASING ❑Yes❑No Bortp Dl:a _ Castro OIL_ Carling DWO ❑ IIUECTION&J;i0LQ0 _ ❑ HAND AUGER GROUT SEAL DEPTH TREME TYPE TO BE USED, ❑AUGERS ❑HOSE ❑PPE ❑ OTHER ❑ OTHER- ^-ROUT SEAL PUMPED? ❑Yn❑No (NM Mofto FmW DWM is 30 FQ WEW SOIL BORING Cs GROUT SPECIFICATIONS DESTRUCTION WORK TO BE PERFORMED: DESTRUCTION MMOD:(CHECK ALL THAT APPLY) t WELLS TO BE DESTROYED 14 ©OVER-BORE DIAIAETER of 8 Itches to Mp11 of 17-37 feet WELL Ws OS-18 through OS-31 ❑PRESSURE GROUT To dep(h of feet below surfer. GROUT SPECIF)CIATIONS at Cement ❑EXPLOSIVES From to___.._fast below surface TREMIE TYPE TO BE USED AUGERS HOSE PIPE MUSHROOM CAP 3 feat below surface or feet below surface 9>3 feet OMMENTS: Wells wig be over-bored unless site conditions prohibit access wrth augers,in which case a variance for pressure grout will be requested. I hereby cafttry UW 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 aN other applicable Callfomia laws, Signed_ l — TdaelCompany Project Geologist, Orion Environmental Print Name Scott Strombefg Dale 9127/19 DEPARTMENT USE ONLY ^ rr Application Accepted B)t I A Dab Issued' b Grout inspection By/Dates: - Destruction Inspection?By/Dabs Faclht iSito Information + FAN" J r Te FA Address 3 O O 0 0.J FA# b C �1 2 FA PE - Z—1 O WP Reviewed By Q• C 13 Work Plan Dale Gs7 C-57 Arwro tram for Dow to So Pod ❑Wa Ws Como ❑W*ks t Carry Wdws ❑Enmednwt PWA ❑ Mows Ag u m ❑Lead Atio y Approwt ❑MFR oMMt.NTsr6oNomoNs:C.( x 2 C.hftf 41 b$ a E 8C FEE INFO ANT REA&MD1 CHECKg REC%FD BY DATE WELL PERMq# INVOICEf- PerTT9t ��Z 3 51b2x CC �z �C 60 06040UIL- 1868 E. Hazelton Avenue) Stockton, California 952051 T 209 468-3420 1 F 209 46"138 1 www.sjcehd.com EHD 2941 06-01-17 SIN MApwaon WON Parrvil Appac"M 59 Z-3 R