Laserfiche WebLink
SAN JOAQUIN <br />• 4Environmental Health Department <br />.\ <br />fr <br />—COUNTY— <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 2. A�l D Inspector: CONSTRUCTION <br />Facility Address: <br />Well Address: 19 6 C EA V'N Lv Total Depth: <br />t <br />WP# o 03.q-qD Well#: M4.14 Drilling Rig Type: <br />SoilBoring#: „ � <br />Drilling Company: It"�Q_ca� 81Vd • Min 2" Annular EHD Seal Verified: El Yes []No <br />Driller Onsite: Screen Length From: To: <br />Consultant: 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 ❑No <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 />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />If yes, material: <br />GROUTING or DESTRUCTION Tot Depth: <br />Depth to Water: j0'_ /Z, s= <br />Grout Material: tae r -P <br />Gallons of Grout Used: r <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation 9�oring Destruction <br />METHOD USED <br />El Pressure Grout e <br />Over Drill <br />❑ Gravity Tremie ❑Other: <br />ft. <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 />ft. <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 />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thi <br />t Thinnest <br />NBM. <br />Thickest Thinnest <br />#Bags <br />2. <br />5 <br />1 <br />5 10 <br />1 <br />5 <br />10 <br />10 20 <br />2 <br />7.5 <br />15 <br />3 <br />15 30 <br />3 <br />10 <br />204 <br />20 40 <br />4 <br />12.5 <br />25 <br />5 <br />25 so <br />5 <br />15 <br />30 <br />6 <br />30 60 <br />6 <br />17.5 <br />35 <br />7 <br />35 70 <br />7 <br />20 <br />40 <br />8 <br />40 80 <br />8 <br />ft. <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 />ft. <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 />