Laserfiche WebLink
SAKJOAQUIN <br />COUNTY <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Z �(B Inpactor. Vv <br />Facility Address:() 4!J in aA <br />Well Address: <br />WP# Well#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: ❑ Yes El No <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 />Cprlll C <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes ❑ No <br />CONSTRUCTION <br />t <br />Total Depth: b �o <br />iI <br />L (:4 ; C�— <br />Drilling Rig Type: 1 <br />Min 2" Annular EHD Seal Verified: ❑ Yes El 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 />COMPLETION ❑ Stove Pipe ❑Christie Box <br />GROUTING or DESTRUCTION. Total Depth: U 1 bol ks) <br />Depth to Water: 16 i 6 c, _ 92(T�ATERIAILS/DEVIE <br />tt• <br />;— <br />Grout Material: Gallons of Grout Used: ��LOPMENT <br />/ Casing Type: <br />❑Well Installation ❑Well Destruction (td�Blank Feet <br />El Boring InstallationAoring Destruction Slot Size: <br />Bags of Cement: <br />METHOD USED Bags Sand/Gravel: <br />❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />AXTremie ❑Other: Type of Method: <br />i rtlN '' g2iAi <br />ter <br />allons <br />Cement 471b <br />Bas <br />Ater <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />ttBags <br />Thickest Thinnest <br />)t Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 <br />15 0 <br />25 50 <br />30 60 <br />5 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 80 <br />8 <br />n. <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.secehd.com <br />