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WP0038104
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038104
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Entry Properties
Last modified
7/24/2018 2:39:26 PM
Creation date
7/24/2018 2:09:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038104
PE
4372
STREET_NUMBER
1271
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
21307028 & 21307020
ENTERED_DATE
3/28/2018 12:00:00 AM
SITE_LOCATION
1271 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
AMeuangkhoth
Tags
EHD - Public
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SANJOAQUIN <br />WI <br />f'r —COUNTY Environmental Health Department <br />q�- .P.• Greotness groves jiffC. <br />C IFCA, <br />r Monitoring Well/Soil Boring Inspection Report <br />Date: Inspector CONSTRUCTION <br />Facility Address: i 6yav4d� n <br />Well Address: To al Depth: // <br />WP# b Well#: Drilling Rig Type: t-1 A b 's <br />Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Drilling Company: L <br />Driller Onsite: 1-\ 110 1tZ Screen Length From: To: <br />Consultant: Vl •Q S [l: (fie -0 Filter Pack From: To: <br />Geologist: M °--tt Bentonite From: To: <br />Public Water System Onsite: <br />Domestic Well Onsite: <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 />Grout From: <br />❑ Yes El No COMPLETION ❑ Stove Pipe <br />❑ Yes ❑ No <br />❑ Yes El No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth:_ <br />Depth to Water: io 51 � s <br />07- <br />Grout Material: zm "—L <br />Gallons of Grout Used: <br />[]Well Installation []Well Destruction <br />j4Boring Installation ❑Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity Oremie ❑Other: <br />Water <br />gall s <br />Cement 471b <br />Bas <br />Water <br />galions <br />Cement 94 lb <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />6 <br />6 <br />17.5 35 <br />7 <br />ali <br />7 <br />20 40 <br />8 <br />To: <br />❑Christie Box <br />M <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />Note - CreW � e <br />pJetfci CA +M6 "55 <br />35- <br />P- �� Sc10/16/2017 <br />G�- vi Vx Y <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />
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