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WP0041439
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041439
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Last modified
12/9/2020 4:17:44 PM
Creation date
12/9/2020 4:06:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041439
PE
4372
STREET_NUMBER
28500
Direction
S
STREET_NAME
KASSON
STREET_TYPE
RD
City
TRACY
Zip
95304-
APN
24138002
ENTERED_DATE
11/13/2020 12:00:00 AM
SITE_LOCATION
28500 S KASSON RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\fgarciaruiz
Tags
EHD - Public
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fo�uiN . <br /> SAN_JOAQUIN <br /> —c- <br /> Environmental Environmental Health Department <br /> Greatness grows herr <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: Sa�:�, CONSTRUCTION <br /> Facility Address: Z$�W �LixSSci7 �r <br /> Well Address: T Total Depth: <br /> WP# 00 Well#: Drilling Rig Type: <br /> Soil Boring#: -TO Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: V\ -19 <br /> 1 <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: k59 i✓Yyurr"er-"Iy. Filter Pack From: To: <br /> Geologist: c GWyt� 13- 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: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> "gON oNHolding Temperature: c�t_En <br /> Method: Ground Sumacs <br /> Screening Method: Dart <br /> Verified Chain of Custody: ❑ Yes El No �n. <br /> tt. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: stoned <br /> "c-ion — 3 <br /> Covered: ❑ Yes ❑Nogrx_ v <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTIOU Total Depth: <br /> Depth to Water: n. n. <br /> Grout Material: oeal - Ckvybt ' - q, �h. <br /> Gallons of Grout Used: : c N\vrr5. MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> .4 <br /> Boring Installation Destruction Bags Size: <br /> 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 /> allons Bas gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags 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 -3 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 /> 15 30 6 30 60 6 <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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