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SU0011950
Environmental Health - Public
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SU0011950
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Entry Properties
Last modified
5/7/2020 11:35:33 AM
Creation date
9/5/2019 10:43:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011950
PE
2608
FACILITY_NAME
PA-1800157
STREET_NUMBER
18201
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
MOUNTAIN HOUSE
Zip
95391-
APN
20945035
ENTERED_DATE
9/19/2018 12:00:00 AM
SITE_LOCATION
18201 W GRANT LINE RD
RECEIVED_DATE
9/6/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\G\GRANT LINE\18201\PA-1800157\SU0011950\APPL.PDF \MIGRATIONS\G\GRANT LINE\18201\PA-1800157\SU0011950\EH COND.PDF \MIGRATIONS\G\GRANT LINE\18201\PA-1800157\SU0011950\EH PERM.PDF
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EHD - Public
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SAN JOAQUIN Environmental Health Departmen <br /> —COU NTY— ) <br /> Monitoring Well/Soil Boring Inspection Report ,3 -{o <br /> Date: t'� Z Inspector: wovw, CONSTRUCTION <br /> Facility Address: yY1�fl"V\4 06k <br /> Well Addre Total Depth: ZZ " <br /> WP# 60—'-?0' Well#: Drilling Rig Type:EF <br /> Soil Boring#: � V <br /> Drilling Company: °�' � in 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: -� Filter Pack From: To: �Q <br /> Geologist: t <br /> Bentonite From: To: <br /> Grout From: To: l <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> O/k <br /> Domestic Well Onsite: ❑ Yes ❑No <br /> casing sl+1-4 <br /> If yes,location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> oNHolding Temperature: CONFLETION co LEn <br /> Method: Gra nd SwIlace <br /> Screening Method: orout f�0 <br /> Verified Chain of Custody: ❑ Yes EJ-No �ft' <br /> ft. i <br /> SPOILS - "— <br /> Contamination Noted: ❑ Yes ❑No = r <br /> If yes,spoils storage Location: .toned <br /> atcien <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: �� -1 L.A � �• __ . <br /> Depth to Water:_ a r tL 21tt' <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction "ems�� Blank Feet Screen Feet <br /> El Boring Installation f oring Destruction Slot Size: <br /> Bags of 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 Bas gallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest ttBags 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 1 50 <br /> 15 1 30 6 30 1 60 6 <br /> 17.5 1 35 7 35 1 70 7 <br /> 20 1 40 8 40 1 80 8 <br /> 10/16/2017 <br /> 1868 E. elton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 www.sicehd.com <br />
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