Laserfiche WebLink
SANJOAQUIN Environmental Health Department <br />—COU NTY— <br />= Greoiness orvrrs here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /d 1� )Ir Inspector: <br />Premise Address: <br />W P#: <br />Well#: 9» <br />Soil Boring#: <br />Drilling Company: 14- v <br />Driller Onsite: <br />Consultant: 4 jw d '--L-C <br />Geologist: aTek e 12,0pbetl' <br />Public Water System Onsite: ❑ Yes g1No <br />Domestic Well Onsite: ❑ Yes RNo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes ❑No <br />cvnil c <br />Contamination Noted: ❑ Yes E] No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />i <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: JV <br />Grout Material: Alco, iFs.�[ti q-7 <br />Gallons of Grout Used: <br />Nell Installation ❑Well Destruction <br />❑Boring Installation ❑Boring Destruction <br />METHOD USED <br />IXpressure Grout ❑Over Drill <br />❑ Gravity Aremie ❑Other: <br />Water <br />allons <br />Cement 47 lb <br />Bas <br />water <br />gallons <br />% <br />Screen Length From: 2>0To: <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 I <br />3 <br />i5 <br />30 <br />3 <br />30 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />35 <br />70 <br />7 <br />20 <br />40 <br />40 <br />9D <br />a <br />CONSTRUCTION <br />Total Depth: 3 <br />Drilling Rig Type: A%% S4c"-�' <br />Grout From: Z� ' To: Y I/ <br />COMPLETION ❑ Stove Pipe XChristie Box <br />casing <br />height " <br />ABOVE -GROUND } Ty EOX <br />CO&FLETION CO�Lt'7ioN <br />Ground Smlaca <br />procrt <br />Zj fl - <br />Z3 t. <br />r <br />stattnd _ My <br />"c on ', — <br />�0 <br />MATERIALS/DEVELOPMENT <br />Casing Type: yV� <br />Blank Z5-, Feet Screen S� Feet <br />Slot Size: . ZO <br />Bags of Cement: <br />Bags Sand/Gravel: Aq i <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: 46, <br />• �YIQ�: �✓J� <br />Type of Method: <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 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.corn <br />Min 2" Annular Seal Verified: 9 Yes <br />11 No <br />% <br />Screen Length From: 2>0To: <br />i <br />ZS <br />Filter Pack From: ' To: <br />Z31 <br />Bentonite From: Z3 To: <br />Z1 <br />Grout From: Z� ' To: Y I/ <br />COMPLETION ❑ Stove Pipe XChristie Box <br />casing <br />height " <br />ABOVE -GROUND } Ty EOX <br />CO&FLETION CO�Lt'7ioN <br />Ground Smlaca <br />procrt <br />Zj fl - <br />Z3 t. <br />r <br />stattnd _ My <br />"c on ', — <br />�0 <br />MATERIALS/DEVELOPMENT <br />Casing Type: yV� <br />Blank Z5-, Feet Screen S� Feet <br />Slot Size: . ZO <br />Bags of Cement: <br />Bags Sand/Gravel: Aq i <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: 46, <br />• �YIQ�: �✓J� <br />Type of Method: <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 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.corn <br />