Laserfiche WebLink
SAN JOAQUIN <br />- - COUNTY- - <br />Date: '-t / fa/ 18 <br />Facility Address:_ <br />Well Address: <br />W P# <br />Soil Boring#: <br />Drilling Company: _ <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />I nspecto <br />V a ir, <br />En-Vilrental Health Department <br />Mo'n.i1toring Well/Soil Boring Inspection Report <br />Jr: CONSTRUCTION <br />3 Well#: <br />/Total Depth: _�— �tI <br />Drilling Rig Type: 10 t -" j . `S <br />Min 2" Annular EHD Seal Verified <br />2 <br />rr,Screen <br />Water <br />gallons <br />Length <br />From: <br />K r, o` ZaA/% Filter Pack <br />From: <br />Bentonite <br />From: <br />Grout <br />From: <br />Public Water System Onsite <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 El No COMPLETION ❑ Stove Pipe <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 3 <br />Grout Material: NI j &A ( p <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />El Boring Installation S�Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity Aremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />1 <br />5 <br />10 <br />1 <br />5 10 <br />2 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 25 <br />25 <br />50 <br />5 <br />15 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 35 <br />7 <br />35 <br />70 <br />7 <br />20 40 <br />8 <br />40 <br />80 <br />8 <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />IF7LT height <br />ABOVE -GROUND Ct4�i5TY 80X <br />CONFLErION COMPLETION <br />Ground Suriaas <br />grout <br />tt. <br />tt. _ <br />v: <br />O <br />O <br />_ o <br />clotted = E <br />socion — B <br />on+el PaCK <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 />I -Q <br />10;; 5 <br />k <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.socehd.com <br />