SR2400288 (3) - Laserfiche WebLink

Home Browse Search

SAN ,10AQUIN Environmental Health Department —COU NTY— r3f Brit fIClS qr 0191 )1Cr 11. SITE MITIGATION WELL & BORING PERMIT APPLICATION NON-REFUNDABLE PERMIT EXPIRES 1 YEAR FROM DATE ISSUED 24 Hours Advance Notice Required For All Inspections CALL (209) 953-7697 For INSPECTIONS Application is hereby made to San Joaquin County for a permit to construct and/or install the work described. This application is made in compliance with San Joaquin County Development Title,Chapter 9-1115.3, and the San Joaquin County Well Standards. Job Address 1810 E. Hazellon Avenue City/State/Zip Stockton, CA 95205 Phone (209) 468-3000 Cross Street S. B Street APN 155-18-002 Property Owner' San Joaquin County General Service Department Phone (209)468-9598 Address 44 N.San Joaquin Street Suite 590 City/State/Zip Stockton, CA 95202 C-57 Contractor V&W Drilling, Inc. License# C57-720904 Phone (209)469-7700 Address 1133 Blackhurst Drive city/StatelZip Galt, CA 95632 Consultant/Sub-Contractor Condor Earth License# - Phone (209)234-0518 Address 188 Frank West Circle, Suite I City/State/Zip Stockton, CA 95206 CONSTRUCTION WORK TO BE PERFORMED; *Note: Ogsite BoringsNVells Require Access Agreements or Encroachment Permits i TYPE OF WELLIBORING NUMBER INSTALLATION TYPE CONSTRUCTION SPECIFICATIONS ❑ MONITORING ❑ HOLLOW STEM BORING DEPTH ❑BOLTED TRAFFIC BOX ❑STOVEPIPE ❑ ETRACTION(Vapor/Waler) ❑ HAMMERIDRIVEN DIA.OF BOREHOLE ❑MULTIPLE CASINGS❑MULTI-LEVEL WELLCASING DIA ❑ SOILVAPORPROBE ❑ MUD ROTARY CASING THICKNESS TYPE OF CASING: ❑STEEL ❑PVC ❑ OTHER ❑ SOILBORING ❑ PUSH POINT(GPI CPT) CONDUCTOR CASING ❑Yes ❑No Boring Dia: Casing Chic: Casing Depth: ❑ INJECTION(48parae.0zme1 ❑ HANDAUGER GROUT SEAL DEPTH TREMIE TYPE TO BE USED: ❑AUGERS ❑HOSE El PIPE ❑ OTHER ❑ OTHER GROUT SEAL PUMPED? ❑Yes ❑No (Note:Maximum Freefall Depth is 30 FQ WEW SOIL BORING IDs GROUT SPECIFICATIONS DESTRUCTION WORK TO BE PERFORMED: DESTRUCTION METHOD: (CHECK ALL THAT APPLY) #WELLS TO BE DESTROYED 22 total:lO morutodrg,7 ozone,3 sdl vapor,2(rested wens ®OVER-BORE D IAMETER of 8 to 10 inches to depth of 6 to 60 feet WELLIDs M'y'it M.w-Ie,OZ-1Gru02-7;SW-ih Sw3;SVE-1PiB.G;SW-291AS-1 El PRESSURE GROUT Todepthof_feet below surface GROUT SPECIFICATIONS Type hill Neal Cement [I EXPLOSIVES From to feet below surface THEME TYPE TO BE USED ❑AUGERS ❑ HOSE ® PIPE ❑MUSHROOM CAP ❑3 feet below surface or feel below surface if>3 feet COMMENTS: MW-1,MW-2,SVE-1AB/C,SVE-2B/AS-1 will be overdrilled with 10'diameter augers to total depth(55 to 60%MW-3 thm lZiO and OZ-1 Ihru OZ-7 will be overddlled with 8'diameter augers to total depth(44-56),and SVP-1 thru SVP-3(1/4'tubing in 21/4'borings)will be overddlled with 8'diameter augers to total depth(6'), Neat cement grout hemmed through pipe from bottom to top in one pour,except SVPs,which will free fall to 6'into open borehole a through augers. I hereby certify that 1 am authorized to complete this application and that the work will be done in accordance with '� '�,,ppl San Joaquin County Ordinance Codes and Standards, and all other applicable California laws. J Signed .JIL � Title/Company PG#6795/Condor Earth Print Name John P.Lane Date June 25.2024 DEPARTMENT USE ONLY � Application Accepted By: Date Issued: Grout Inspection By/Dates: 3 2, — M._ 1101 ) a V 0 Destruction Inspection By/Dates: Facilit /Site Information FA Name CON t-�m FA Address t $ �0 +jq J.L � FA# PRO n FA PE 2- 9 1 WP Reviewed By w Work Plan Dale S o4fl`1 ❑G-57 G-51 Authorization for Othertu Sign Permit ❑Worker's Comp ❑Workers Comp Waiver ❑Eoaoachment PBrmk ❑Aa:ess Agreement Lead AgenyAppmval AMFR COMMENTS/CONDITIONS: /( QC }3 t r 3 /1 zo ;Za o- ` -f:le• ERV Pzyeu �o Pre-PaW M°v��C o -k 20 kowrs �nSEQ 2Z tnl & S iACe 41w- 3 ✓ oJr wells ar ( er, bj� 4 ,E any :sb; I"le WP TYPE PE I SC FEE INFO AMT REMITTED CHECK# RECV'D BY DATE WELL PERMIT# INVOICE# Permit NOZ 13J3 1$162X 20 1 3i40 I 4G I 5 W 14/zs ulf WpZ40o6q* Ccff I 6 �- Lt5- 3.S Sg2(to028T 1868 E. Hazelton Avenue I Stockton, Cali ornia 9520 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com EHD 29-01 04-04-07 Site Mitigation Well PermitApplicztien AP 2xto0C2o