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WP0039426
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039426
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Entry Properties
Last modified
4/29/2019 2:29:50 PM
Creation date
4/26/2019 12:06:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039426
PE
4372
STREET_NUMBER
2201
Direction
W
STREET_NAME
WASHINGTON
STREET_TYPE
ST
City
STOCKTON
Zip
95203-
APN
14503001
ENTERED_DATE
3/13/2019 12:00:00 AM
SITE_LOCATION
2201 W WASHINGTON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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AMeuangkhoth
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EHD - Public
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r z SAN J O A Q U I N Environmental Health Department <br /> LiIK —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: SUX4-w ,fi' CONSTRUCTION <br /> Facility Address~ 2 2 b I Vjo.,Nii,j(y tpA gt <br /> Well Address: �T Total Depth: <br /> WP# 00 Well#: Drilling Rig Type: <br /> Soil Boring#: 10 Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: cc AI h1 <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: jiy Ua Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes E]No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING A8OVE-GROUND <br /> Holding Temperature: COWLETION CCOWLE-noN <br /> Method: Ground Su facs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes 1:1 No �ft. <br /> ft. <br /> ft. <br /> SPOILS = <br /> = o <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: atottQe <br /> sacdon <br /> Covered: ❑ Yes ❑No - VW <br /> If yes, material: " <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: ft• — ft• <br /> Grout Material: t JeA MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity 'Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water ent 41 <br /> allons Bas Fallons Ba <br /> Thickest Thinnest tlBags Thickest Thinnest IBags Bentonite/Cement Mix 3% Mix 5% 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 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> IS 30 6 30 0 6 <br /> 7 I �/lwv i <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />
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