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WP0038771
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038771
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Last modified
10/25/2018 12:27:13 PM
Creation date
10/25/2018 12:02:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038771
PE
4372
STREET_NUMBER
880
Direction
N
STREET_NAME
GUILD
STREET_TYPE
AVE
City
LODI
Zip
95240-
APN
04933008
ENTERED_DATE
9/13/2018 12:00:00 AM
SITE_LOCATION
880 N GUILD AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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•.Q�°R""" �� SAN�JOAQUIN <br /> Environmental Health Department <br /> r ,-�' j —COUNTY— <br /> \'Oa�, naaPl Greatness grows here <br /> 0� (� <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 12� D Int CONSTRUCTION <br /> ry�N CONSTRUCTION <br /> dd <br /> Facility Ares : R � r: , AUZLD <br /> Well Address: Total Depth:)S <br /> WP# Well#: Drilling Rig Type: 9" Cyd STS/h <br /> Soil Boring#: ' <br /> Drilling Company: Min 2" Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: 006PLETION COMPLETION <br /> Method: Giround Surface <br /> Screening Method: ar«n <br /> Verified Chain of Custody: ❑ Yes ❑No �ft' <br /> it. <br /> it. <br /> SPOILS K <br /> Contamination Noted: ❑ Yes ❑No <br /> r <br /> If yes, spoils storage Location: abtted <br /> taction <br /> Covered: ❑ Yes ❑No <br /> 9-61 Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: AJOT I�NCOun,7Ee68 <br /> Grout Material: T [', y"I MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 2t'� G► <br /> �� Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Aoring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bags gallons Bags <br /> Thickest Thinnest &Bags Thickest Thinnest &Bags Bentonite/Cement Mix 3% Mix 3%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 30 3 <br /> 10 20 40 4 <br /> 12. 5 25 50 5 <br /> 15 30 30 60 6 <br /> 17.5 1 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/1 /2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.sacehd.com <br />
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