Laserfiche WebLink
SKJOAQUIN <br />COUNTY— <br />c9tiFoaP� Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: ,%�-2( Inspector: <br />Facility Address: !�Jff? L ' �s,���..��cstrl O/Z <br />Well Address: <br />WP#DD q/Z/�3 Well#: <br />Soil Boring#: <br />Drilling Company 10/ CC�ad1� <br />Driller Onsite: <br />Consultant: X12, Cr'rG <br />Geologist: T/1/x5L%a K <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 <br />SPOILS <br />Contamination Noted <br />If yes, spoils storage Location: <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Covered: ❑ Yes El No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: t 5� <br />Depth to Water: 1 ' <br />Grout Material: NAs ce"w <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation L/Boring Destruction <br />METHOD USED <br />❑Pressure Grout []Over Drill <br />❑ Gravity Vremie ❑Other: <br />ter <br />allon <br />Cement 471b <br />Bas <br />water <br />allons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />It 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 />3 <br />15 30 <br />3 <br />10 204 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />30 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 80 <br />8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />From: <br />From: <br />From: <br />From: <br />❑ Stove Pipe <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <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 />o •4� GAY 2 � � <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 <br />10/16/2017 <br />www.s*cehd.com <br />