Laserfiche WebLink
SKJOAQUIN <br />Environmental Health Department <br />I" r -ti' ' '—COUNTY— <br />Greatness <br />—COUNTY— <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: I Inspector: t; t� <br />Facility Address: 13�i �, �ac�rFwu•+.�v1' <br />Well Address: <br />WP# !!I 2J3 6 Well#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: r i( ZA <br />Consultant: L'i V; o L <br />Geologist: VtAl jvXs( <br />Public Water System Onsite <br />Domestic Well Onsite <br />If yes, location and distance: <br />CABAPI IfVr, <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 />❑ Yes ❑ No <br />❑ Yes []No <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 />casing <br />height <br />ABOVE -GROUND Q} S*'TY43OX <br />CONFLEMN COMPLETION <br />Ground surface <br />grout <br />�- ft. <br />n. <br />n. <br />— e <br />_ o <br />810 <br />eec2on <br />Covered: ❑ Yes ❑ Nograys, Pack <br />t1' <br />If yes, material: S V I'; �4 k __ <br />GROUTING or DESTRUCTION Total Depth: y V I <br />Depth to Water: vv -A- AwLtA4,t A� <br />Grout Material: oV 4--L MATERIALS/DEVELOPMENT <br />Gallons of Grout Used: t. C, <br />Casing Type: <br />E]Well Installation �1/ell Destruction {�ot��°� Blank Feet <br />❑Boring Installation ❑BSlot Size: <br />oring Destruction Bags Size: <br />Cement: <br />METHOD USED �r� Bags Sand/Gravel: <br />El Pressure Grout [Over Drill Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />❑ Gravity Pdxremie ❑Other: Type of Method: <br />Water <br />allons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />NBags <br />2.5 5 <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 10 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 1 80 <br />8 <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.s*cehd.com <br />