Laserfiche WebLink
SAN J OA Q U I N Environmental Health Department <br /> COU�,JTY- <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ]/�! Inspector: ^ CONSTRUCTION <br /> Facility Address: /e261 GGA:-i it l..ne / <br /> Well Address: Total Depth: <br /> WP# d0Well#: Drilling Rig Type: <br /> Soil Boring#:�.2L3 <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> 1 <br /> Drilling Company: /� �— <br /> Driller Onsite: Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: <br /> Bentonite From: To: <br /> Geologist: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: I?flT height <br /> SAMPLING ABOVE-GROUND <br /> GOt��1ON <br /> Holding Temperature: CCMPLE IcN <br /> Method: Grvurd Surface ' f _ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No 4r ft. <br /> n. <br /> —ft. <br /> SPOILS <br /> _ -a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: <br /> atoned = a <br /> a :on + = <br /> Covered: ❑ Yes ❑No <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: gr M <br /> Depth to Water: n' <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation kBoring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie J$Othejl Type of Method: <br /> at r " <br /> nt 4 Water cement 941b <br /> aIto Bas eallons Bags <br /> Thi est Thinnest z8ags Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 1 35 70 7 <br /> 20 40 8 40 80 8 <br /> SD 15- 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s4cehd.com <br />