Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br /> --COUNTY-- <br /> `�c!Fool"' Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �,2 21 Zl Inspector: (I x5 CONSTRUCTION <br /> Facility Address: (-Cl(1a viple <br /> Well Address: Total Depth: <br /> WP# bog 2-+ Well#: Drilling Rig Type: <br /> Soil Boring#: —4 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: VAi L� t-ai-fit btb1 W('I <br /> Driller Onsite: JJ Screen Length From: To: <br /> Consultant: `1C Filter Pack From: To: <br /> Geologist:Jam' �j Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMOO <br /> COMPLETION CMPLEncN <br /> Method: G=nd Sumacs <br /> Screening Method: gran <br /> Verified Chain of Custody: ❑ Yes El No —n' <br /> ft. <br /> tt. <br /> SPOILS =_ <br /> A0. C <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes, spoils storage Location: abnad <br /> soon — <br /> Covered: ❑ Yes ❑No : <br /> If yes, material: <br /> � I�` _ <br /> GROUTING or DESTRUCTION Total Dept �� _ <br /> IF <br /> Depth to Water: Wk. n tt' <br /> Grout Material: ��� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used• A <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation NBoring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity KTremie� ❑Other: Type of Method: <br /> Water Cegent 471b Water Cement 94 lb <br /> allons / Bas gall ons Bags <br /> Thickest Thinnest ags Thickest Thinnest nBags 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 z 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 7 35 70 7 <br /> 20 40 8 11 40 1 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.sicehd.com <br />