Laserfiche WebLink
SAN 1UA[�UIN <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /Z r� Inspector: �► f�✓� <br />Facility Address: I�Zc��i � . Mu rc� �.-ur� <br />Well Address: <br />wP# �c} �13r/�9 well#: �Y►���-� t t <br />Soil Boring#: <br />Drilling Company: ��TSGI� <br />Driller Onsite: �y%�` <br />Consultant: �f� <br />Geologist: ��� <br />Public Water System Onsite: ❑Yes ❑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 />Covered: <br />If yes, material: <br />❑ Yes <br />❑Yes <br />❑Yes <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: '. � ��� <br />Grout Material: ll►��'�9 �.-�.�i��� <br />Gallons of Grout Used: `� i �� �'����� <br />❑Well Installation Q'�11/ell Destruction <br />❑Boring Installation ❑Boring Destruction <br />METHOD USED <br />❑Pressure Grout❑Over Drill <br />❑ Gravit LsdTremie ❑Other: <br />Y <br />❑ No <br />❑No <br />❑ No <br />�f <br />�s <br />Water <br />allons <br />Cement 471b <br />ea s <br />3°�° Mix <br />Water <br />allons <br />Cement 941b <br />Ba s <br />Thickest <br />Thinnest <br />it Bags <br />4.7 <br />Thickest <br />Thinnest <br />� gags <br />2.5 <br />5 <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 />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑Yes ❑No <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />COMPLETION <br />❑ Stove Pipe ❑Christie Box <br />casing <br />height <br />- - ►- :. <br />.. - <br />.. <br />`V <br />ft. <br />::: — <br />>� _' . <br />>�` _ <br />sloct�d <br />aac'Jon --' _ <br />�, — <br />�� _ '. <br />�,, <br />..�t: — <br />tc. �� _ - <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 />Feet <br />BentonitefGement Mix <br />3°% Mix <br />3°�° Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />Bentonite per 94 Ib <br />2.82 <br />4.7 <br />f/'7/� <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sjcehd.com <br />