Laserfiche WebLink
SAN JOAQUIN <br />r wiry') COUNTY <br />vt,/ Greatness grows here .ff <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date9 I 9/0)•-'6021 Inspector: <br />Facility Address: 22 . <br />Well Address:'Z\ W, 004.,K <br />wP#O(19I .0 <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />CONSTRUCTION <br /> <br />watt: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: W1'L1 <br />Consultant: ; 14X1./03 1c_Ii <br /> VOLE--; vt. <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: III Yes 111No <br />To: <br />To: <br />To: <br />To: <br />Public Water System Onsite: El Yes 111No COMPLETION El Stove Pipe 0Christie Box <br /> <br />Domestic Well Onsite: DI Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes EINIo <br />SPOILS <br />Contamination Noted: El Yes ON° <br />If yes, spoils storage Location: <br />Covered: <br /> El Yes <br />If yes, material: <br />ABOVE-GROUND <br />COMPLETION <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />C3round Surface <br />tt <br /> tt <br />_ft <br />slotted <br />secdon <br />gravel pack 0No."..2 <br />t,\ c19.)S-AVI) <br />GROUTING or DESTRUCTION Total Depth:________ <br />Depth to Water: <br />Grout <br />- <br />Grout Material: /Vekt- ce.inoef <br />Gallons of Grout Used: (."- 1'301 0.-A <br />E Well Installation 'Well Destruction <br />El Boring Installation CIBoring Destruction <br />METHOD USED <br />El Pressure Grout *ver Drill <br />r - . Gravity <br /> <br />IlTrerrlYirEOther: <br />Water <br />gallons <br />Cemer‘r7 lb <br />./ <br />Water <br />gallons <br />Cement 941b <br />Bags Ba <br />Thickest Thinnest 8 Bags Thickest Thinnest rr Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 <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 7 35 70 7 <br />20 .40 8 40 80 8 <br />ft. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen 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 />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />ft. <br />4-46 )aJ Z010 S 1 1868 E. Hazelton Avenue I Si kton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com <br />10/16/2017