Laserfiche WebLink
SAN,JOAQU1N Environmental Health Department <br />—COUNTY— <br />Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 22 Inspector: CONSTRUCTION <br />Facility Address: 1 k' . (,q <br />Well Address: AZ I Total Depth: <br />WP# Well#: Drilling Rig Type: <br />Soil Boring#: <br />� Min 2" Annular EHD Seal Verified <br />Drilling Company: S LA ES'�'Qs <br />Driller Onsite: Screen Length From: <br />Consultant: OM� Filter Pack From: <br />Geologist: Bentonite From: <br />Grout From: <br />Public Water System Onsite: ❑ Yes 0 N <br />Domestic Well Onsite: /Yes ❑No <br />If Yes, and distance: /�%�e, <br />2 <br />Cr1AAPl IN(' <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 />Covered: <br />❑ Yes ❑No <br />❑ Yes /N0 <br />❑ Yes /No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 0, <br />Depth to Water: Vol /� <br />Grout Material: I G <br />Gallons of Grout Used: fAcn <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation 013oring Destruction <br />nAFTWnn I ICFn <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity �Tremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />allons <br />Cement 941b <br />Bags <br />Thickest Thin <br /># B1111911 <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <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 80 <br />8 <br />COMPLETION ❑ Stove Pipe <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />M <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/Gement 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 />