Laserfiche WebLink
" SANsJOAQUIN <br />,'. --COUNTY-- <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 1 /I Inspector: <br />Facility Address: + <br />Well Address: <br />WP# n 10 al Well#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: t <br />Public Water System Onsite <br />Domestic Well Onsite <br />If yes, location and distance: <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type <br />4Is-A L- <br />jk <br />Min 2" Annular EHD Seal Verified: ❑ Yes 11 No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />❑ Yes EJ No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑No <br />SAMPLING <br />Holding Temperre: <br />bEzwZS <br />Method: ra.9,h S <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />1 <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material:ON <br />Gallons of Grout Used: CL <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation dl� <br />ring Destruction <br />METHOD USED V <br />❑Pressure Grout ❑Over Drill <br />/5� Gravity ❑Tremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thi <br />est <br />s <br />Thickest Thinnest <br />ttBags <br />2.5 <br />5 <br />V5 <br />10 <br />1 <br />5 <br />0 <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 />25 <br />5 <br />25 50 <br />5 <br />15 1 <br />30 <br />6 <br />30 60 <br />6 <br />17.5 1 <br />35 <br />7 <br />35 70 <br />7 <br />20 1 <br />40 <br />8 <br />40 80 <br />8 <br />casing <br />height <br />A OVE-GROUND CHRISTY-Box <br />COMPLETION COMPLETION <br />Ground Surfers <br />grout <br />ft. <br />ft. _ <br />_ o <br />stoned <br />soc:on <br />_ = gravel Pack <br />�x _ <br />tt. = n. <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 />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s*cehd.com <br />