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WP0043027
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043027
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Last modified
11/20/2024 8:50:38 AM
Creation date
4/1/2022 1:16:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043027
PE
4372
STREET_NUMBER
18527
Direction
E
STREET_NAME
STATE ROUTE 26
City
LINDEN
Zip
95236-
APN
09120037
ENTERED_DATE
3/2/2022 12:00:00 AM
SITE_LOCATION
18527 E HWY 26
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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SAN JOAQUIN <br />COUNTY— <br />_ �n <br />Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 3 ��al Inspector: (s tta"r�k CONSTRUCTION <br />Facility Address: gi.5 -jT eZT 7-G i L_1A .A j <br />Well Address: _. _ Total Depth: _ <br />WP# A10- Well#: Drilling Rig Type: <br />Soil Boring#: Pj> t. <br />Min 2„ Annular EHD Seal Verified <br />❑ Yes ❑ No <br />Drilling Company: D ICON-,, <br />Cement 471b <br />Bas <br />Water <br />eallons <br />Cement 941b <br />Bags <br />Driller Onsite: 1—.rcL1Ak <br />Screen Length <br />From: <br />To: <br />Consultant: �n,�f <br />Filter Pack <br />From: <br />To: <br />Geologist: (1��, h <br />Bentonite <br />From: <br />To: <br />7.5 15 <br />Grout <br />From: <br />To: <br />Public Water System Onsite: ❑ Yes ZNo <br />COMPLETION <br />❑ Stove Pipe <br />❑Christie Box <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes eT—No <br />❑ Yes ❑ No <br />❑ Yes KNo <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth: lji' <br />Depth to Water: <br />Grout Material: 4'4 - <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation 'Poring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />stoned <br />asc .an <br />�("ZS <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />eallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />4 Bags <br />Thickest Thinnest <br />u Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />i1h 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 80 <br />8 <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: _ <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s*cehd.com <br />
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