Laserfiche WebLink
SAN.. J UAQU IN <br />--COUNTY <br />'1 FOaV�"' Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: �is�/ Inspector: M9344 -PA <br />Facility Address: Z-615-0 5. T` <br />Well Address: <br />WP# (0 5ro(p j Well#: <br />Soil Boring#: b 3 <br />Drilling Company: ti4w <br />Driller Onsite: A61G <br />Consultant: er'4 we" Zk-e_ <br />Geologist: _ _ &� <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />CAKAD1 IKIr, <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 />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />From: <br />Filter Pack <br />From: <br />Bentonite <br />From: <br />Grout <br />From: <br />❑ Yes El No COMPLETION ❑ Stove Pipe <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 71 <br />Grout Material: ccn-r1vZ" <br />Gallons of Grout Used: <br />❑Well Installation []Well Destruction <br />❑Boring Installation ABoring Destruction <br />METHOD USED <br />INPressure Grout ❑Over Drill <br />❑ Gravity XTremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />9Bags <br />Thickest Thinnest <br />7t 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 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 1 <br />25 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 1 <br />8 <br />40 <br />80 <br />8 <br />❑ Yes ❑ No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />ABOVE -GROUND CHRLS'TY43OX <br />COMPLETION COMPLEr1CN <br />Ground surface <br />grout <br />n. <br />K. <br />ft. <br />`4 O <br />= o <br />— o <br />slotted <br />sac5on — <br />= gravel pads <br />ft. ==I <br />tt. <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.sicehd.com <br />