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SR0082833 (2)
Environmental Health - Public
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2900 - Site Mitigation Program
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SR0082833 (2)
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Last modified
3/16/2021 12:47:54 PM
Creation date
3/16/2021 12:29:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
SR0082833
PE
2903
FACILITY_ID
FA0026223
FACILITY_NAME
INGREDION
STREET_NUMBER
1021
STREET_NAME
INDUSTRIAL
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
17728012
ENTERED_DATE
11/5/2020 12:00:00 AM
SITE_LOCATION
1021 INDUSTRIAL DR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SANJOAQUIh Environmeimcal Health Department <br /> COUNTY <br /> ."- � '. � ' Grr-.otness grativs here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: '\ 10 20� b Inspector: \Ind OAA CONSTRUCTION <br /> Facility Address:_ jp21 \'(\kkU TYla\ VY.' <br /> Well Address: \42\ \Y1dUSVVW p f . Total Depth: <br /> WP# 0 u G\A \__�- Well#: Drilling Rig Type: <br /> Soil Boring#: (A Mp kYi G\S fi0nU 1l &X-P—q <br /> Drilling Company: fttffit ,M\Q1 <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> ( <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: unmQ (lfl(1 Filter Pack From: To: <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 El No casing <br /> If yes, location and distance: height <br /> SAMPLING <br /> nsov>`.Gaoucao ct�wtsr�r-aax. <br /> Holding Temperature: �&F �N CCMPt.ETiON <br /> Method: Ground Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> ft. <br /> ft. <br /> SPOILS - <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: atone <br /> Covered: El Yes El No aaodon — <br /> iib gmvw Packs <br /> If yes, material: <br /> N <br /> GROUTING or DESTRUCTION Total Depth: , l t <br /> Depth to Water: N \N ft• <br /> Grout Material: Cj(Y knf 4U0 bu►a MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: I- _1 q Cl I I(1(1S Casing Type: <br /> ❑Weil Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation VBoring 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 ktremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas allons Bags <br /> Thwknst Thinnest 9 Bags thickest Thinnest :t Bags Bentonite/cernent MIX 3% MIX 5J"/. Mix <br /> j 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 /> 15 30 6 30 60 6 <br /> 17.5 35 1 7 35 70 7 <br /> 20 40 1 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />
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