Laserfiche WebLink
SAN JOAQUIN <br />_ -COUNTY--- <br />°'1 aPN1" Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date:Inspector: 'Biem T10 <br />Facility Address: <br />Well Address: 91 (DO 0 1 ' (0 LEW <br />WP# W _,, Well#: <br />Soil Boring#: <br />Drilling Com pan : r(� CON <br />Driller Onsite: ((} <br />Consultant: W N'e <br />Geologist: LL- <br />13ioLbCoIS��No <br />74 M) <br />Public Water System Onsite: ❑ Yes <br />Domestic Well Onsite: Yes $No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chai f Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils stora ocation: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: n Cf✓�fi <br />Gallons of Grout Used: 'y 0 0— ((Z <br />❑Well Installation ❑Well Destruction <br />Aoring Installation ❑Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity ❑Tremie ),Other: l� <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />NBags <br />Thickest Thinnest <br />Jt 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 />12.5 <br />5 <br />25 50 <br />5 <br />15 1 <br />k30j6 <br />30 60 <br />6 <br />17.5 <br />35 <br />35 1 70 <br />7 <br />20 <br />40 <br />8 <br />40 1 80 <br />8 <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />rnmpi FTlnlU <br />From: <br />From: <br />From: <br />From: <br />❑ Stove Pipe <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />—VI '•F <br />ABOVE -GROUND CHMSTY-BOX <br />COWLETION compLE710N <br />Ground Surface <br />grout <br />�- ft. <br />ft. <br />ft. <br />= o <br />— o <br />slatted <br />a <br />tec;ion <br />gravel Pack <br />�K = <br />T= <br />ft. =I Fft. <br />MATERIALS/DEVELOPM ENT <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 3% 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />