Laserfiche WebLink
SANrJOAQUIN <br /> Environmental Health Department <br /> COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: rP /u'2`f Inspector: &eo— CONSTRUCTION <br /> Facility Address:_4 L/4nV <br /> Well Address: Total Depth: <br /> WP# t& Zil"26j Well#: Iv-L4 IQP7W-17 Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: ( -/RS Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: ✓><at.5 C Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: [xf% d' Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes ONO Y casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> CO&FLEfION CHRISTKHOX <br /> Holding Temperature: coMalEnoN <br /> Method: G=nd s"t'o' '+ <br /> Screening Method: arart <br /> Verified Chain of Custody: ❑ Yes ❑No —n <br /> ft. <br /> SPOILS =_ <br /> e <br /> Contamination Noted: ❑ Yes ONO <br /> If yes,spoils storage Location: = s <br /> slatted = B <br /> n <br /> Covered: ❑ Yes ONO If yes, material: c -„ <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: tt• — TM <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> a� Casing Type: <br /> ❑Well Installation XWell Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> rPressure Grout Dover Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity kremie ❑Other: Type of Method: <br /> Water Cement47lb Water Cement 94lb <br /> allons Bags allons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest if Bags Bentonite/Cement MIX 3% MIX 5%MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1 1.411 2.47 <br /> 5 10 2 i0 20 2 Bentonite per 94 lb 1 2.821 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 7 35 70 7 <br /> 20 40 8 40 80 8 <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 />