Laserfiche WebLink
SANJOAQUIN <br />—COUNTY — Environmental Health Department <br />cjr Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 6 5h Inspector: �/Jil�1G��V✓I l V�- <br />Facility cldress: 09 S, �? pile -Ty u Z -n <br />Well Address: <br />WP# Well#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />CONSTRUCTION <br />Total Depth:_ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: <br />Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe <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: ❑ Yes ❑No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />To: <br />❑Christie Box <br />casing <br />height <br />A3CVE-GaouND c7-07ST r aox <br />COMPLETION COMPLETION <br />Ground Surfxs <br />grout <br />ft_ <br />Al <br />ft. <br />ft. <br />tiK � C <br />1 <br />= o <br />O <br />s[onad <br />sac�on <br />- _ <br />GROUTING or DESTRUCTION Total Depth:a� '_. =_ <br />Depth to Water: ft•' <br />Grout Material: O -pVL4�-� -5 11' F <br />Gallons of Grout Used: I MATERIALS/DEVELOPMENT <br />Casing Type: <br />[]Well Installation Nell Destruction Blank Feet <br />❑Boring Installation ❑Boring Destruction / Slot Size: <br />Bags of Cement: <br />METHOD USED T Bags Sand/Gravel: <br />❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Gravity ❑Tremie ❑Other: Type of Method: <br />Water <br />gallons <br />Cement 471b <br />Baas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />2.5 <br />5 <br />1 <br />5 10 <br />1 <br />5 <br />10 <br />2 <br />10 20 <br />2 <br />7.5 <br />15 <br />3 <br />15 30 <br />3 <br />10 <br />20 <br />4 <br />20 40 <br />4 <br />12.s <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 />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 />1888 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />