Laserfiche WebLink
r. � <br />._. <br />%�_:+ uR: <br />,K ; -. <br />j�;� � ,;. <br />9/� /, <br />SAN 10AQlIIN <br />COUNTY <br />Greatness �rar�s here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />���y��Cr <br />Date: � Inspector: � CONSTRUCTION <br />Facility Address: � Z� � G 'ti'�cti 'f�-�" St �,,�..�'j(�✓ <br />Well Address: <br />WP# � �� Well#: �� �� �T <br />Soil Boring#: <br />Drilling Company: � Il/v��-�� % �'-C> <br />Driller Onsite: <br />Consultant: � �pL�.�-- - > v <br />Geologist: � t,..- � � �� S� �- <br />Public Water System Onsite: <br />Domestic Well Onsite: <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 />Covered: <br />If yes, material: <br />Total Depth: <br />� � Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑Yes <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />S' <br />GROUTING or DESTRUCTION Total Depth: S� <br />Depth to Water: �l!'y l �=�,�Y L �--G[�� �..�rt <br />Grout Material: .raw ^ � �Z"��'4%r— <br />Gallons of Grout Used: S, 3', 1 � <br />❑Well Installation Nell Destruction <br />❑Boring Installation ❑Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />ravity ❑Tremie ❑Other: <br />�U � <br />� vim` <br />Water <br />allons <br />Cement 47ib <br />Bas <br />5% Mix <br />Water <br />allons <br />Cement 941b <br />Ba s <br />Thickest <br />Thinnest <br />#Bags <br />4.7 <br />Thickest <br />Thinnest <br />„Bags <br />2.5 <br />S <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17,5 <br />35 <br />7 <br />3S <br />70 <br />7 <br />20 <br />4o <br />s <br />4o <br />so <br />s <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />COMPLETION <br />❑No <br />❑ Stove Pipe ❑Christie Box <br />- . <br />O <br />:. - <br />�- :. <br />«. <br />�. . <br />� .. <br />l <br />�� <br />..�fi. <br />3% Mix <br />5% Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />— <br />2.82 <br />4.7 <br />`;. <br />.A; <br />., <br />sr: <br />}�. <br />=�- <br />- <br />sbtz� <br />: to <br />salon <br />F_ <br />�ti- <br />�. <br />.. <br />:A` <br />— <br />��� <br />. <br />� <br />it. <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 />�� � <br />Screen <br />ft. <br />Feet <br />Ben#onitefOement Mix <br />3% Mix <br />5% Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />Bentonite per 94 Ib <br />2.82 <br />4.7 <br />10/16/2017 <br />1888 E. Hazelton Avenue J Stockton, California 95205 J T 209 468-3420 J 1= 209 464-0138 J www.sjcehd.com <br />