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WP0043361
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043361
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Last modified
7/20/2022 2:06:55 PM
Creation date
7/6/2022 8:27:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043361
PE
4372
STREET_NUMBER
10808
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210-
APN
12002002
ENTERED_DATE
6/2/2022 12:00:00 AM
SITE_LOCATION
10808 N WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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SAN 10AQUIN <br /> '2JJ Environmental Health Department <br /> COUNTY <br /> Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �Z�7i�— Inspector: (5-LI Ct V-C I CONSTRUCTION <br /> Facility Address: LO-30� yu LQA_S ,vim <br /> Well Address:_I 012�; � +^W Total Depth: <br /> WP# 1A 'Zi �7 Well#: Drilling Rig Type: <br /> Soil Boring#: pi0, Dt3 , 1)1 <br /> Drilling Company: l.J �7 �(� Min 2" Annular EHD Seal Verified: El Yes []No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: f gZL Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes eErNo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes -ETN—o casing <br /> If yes, location and distance: Iff height <br /> Off— _qWT <br /> SAMPLING ABOVEGROUND <br /> Holding Temperature: COMPLETION ccoMPt..ET1oN <br /> Method: Ground Surface <br /> Screening Method: grow <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> n. <br /> ft. <br /> SPOILS ; <br /> �v4 o <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: atottpd <br /> ase'on <br /> Covered: ❑ Yes ❑No ,� <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: Z I. t' i <br /> Depth to Water: o qr <br /> n' <br /> Grout Material: f of <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> El Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ,,O-Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 47 lb Water Cement 941b <br /> allons Bas qallons Bags <br /> Thickest Thinnest BBags 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 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 7 35 70 7 4� <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.slcehd.com <br />
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