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WP0040247
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040247
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Entry Properties
Last modified
1/23/2020 9:09:13 AM
Creation date
1/23/2020 8:55:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040247
PE
4372
STREET_NUMBER
522
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376-
APN
23303009
ENTERED_DATE
11/4/2019 12:00:00 AM
SITE_LOCATION
522 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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SAJOAQUIN Environmental Health Department <br /> C O U N TY— <br /> =�s Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: k.SQetero CONSTRUCTION <br /> Facility Address:5aa w. C-w-a<A jmne M. <br /> Well Address: Total Depth: <br /> WP# Oo140-)A-i- Well#: Drilling Rig Type: zA-�3� <br /> Soil Boring#: B-*1 <br /> Drilling Company: Min 2"Annular EHD Seal Ve1`lzfied: ❑Yes ❑No <br /> Driller Onsite: C'hri's Screen Length From: To: <br /> Consultant: Nraalan to A_�, Filter Pack From: To: <br /> Geologist: wC►vn2 Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes []No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No <br /> casirxg . <br /> If yes, location and distance: height <br /> SAMPLING a�sovA�utti3 <br /> Holding Temperature: COWLEM a $° <br /> ctF rrc�tt <br /> Method: GrWnd sufxa <br /> Screening Method: �rj <br /> Verified Chain of Custody: ❑Yes ❑No �'----ft <br /> SPOILS ' —" <br /> Contamination Noted: El Yes ❑Nod <br /> If yes,spoils storage Location: <br /> man <br /> Covered: ❑ Yes ❑No <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: a\' <br /> Depth to Water: 00-4,0— .. ... fL <br /> Grout Material: wt.cA- rex�a�n-V' <br /> Gallons of Grout Used: -•.,-4-1 �\ MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation Boring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Driii Filter Pack Type/Size: <br /> 1K Gravity ❑Tremie ❑Other: Type of Method: <br /> water Cement 471b Water cement 941b <br /> ailons Bads lions pa <br /> Thickest Thinnest 4Bags Thickest Thinnest nBags BentonifefOetnent Infix : to Mix s% Mi-x <br /> z5 s 1 s 10 1 Benfonifeper 47Ib 1.41 2.x•7 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.T <br /> 7.5 15 3 i5 30 3 t <br /> 10 20 4 20 40 4 <br /> 12,5 25 5 25 50 5 <br /> 15 30 S 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> } bays 10/16/2017 <br /> 1868 E. Hazelton Avenue } Stockton, California 95205 ( T 209 468-3420 ( F 209 464-0138 1 www.sicehd.com <br />
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