Laserfiche WebLink
SAN J 0 A Q U I N Environmental Health Department <br /> --- C O U N T Y ------ <br /> <; , , Greatness grows here <br /> Monitoring Well / Soil Boring Inspection Report <br /> Date : 2� 2I Inspector : ) Oji CONSTRUCTION <br /> Facility Address , 3 . L� C / '14 `R <br /> Well Address : ) s - ' 101Total Depth : <br /> WP # � b tg � ell # . A 1/1/—S Drilling Rig Type . <br /> Soil Boring# : Min 2 " Annular EHD Seal Verified : ❑ Yes 11 No <br /> Drilling Company : �P 0 <br /> Driller Onsite : <br /> Screen Length From : To : <br /> Consultant : AAea4q � <br /> Filter Pack From : To . <br /> Geologist : <br /> 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 /> �700 1 T <br /> SAMPLING AaovE-GRCUND __ <br /> HRIX <br /> Holding Temperature , CO ' ON CC+v PtET0N <br /> Method : Ground surlacs <br /> Screening Method , grout <br /> Verified Chain of Custody : ❑ Yes ❑ No ft - <br /> ft . <br /> it . <br /> SPOILS u . <br /> 3 O <br /> Contamination Noted : ❑ Yes ❑ No T <br /> C <br /> If yes , spoils storage Location : <br /> soon <br /> Covered : ❑ Yes ❑ No r` <br /> If yes , material : <br /> GROUTING or DESTRUCTION Total Depth : _= <br /> Depth to Water : 12 ie4ft- �, n • <br /> Grout Material : peu^ MATERIALS / DEVELOPMENT <br /> Gallons of Grout Used : ,�-- 50 <br /> Casing Type : <br /> ❑ Well Installation Vell Destruction Blank Feet Screen Feet <br /> ❑ Boring Installation ❑ Boring Destruction Slot Size : <br /> Bags of Cement : <br /> METHOD USED Bags Sand / Gravel : <br /> Type/ Brand of Bentonite : <br /> ❑ Pressure Grout')4Over Drill <br /> Filter Pack Type /Size : <br /> 'ElGravity remie ❑ Other : Type of Method , <br /> Water Cemen 471b Water Cement 941b <br /> grallens Bads qallons Bags <br /> Thickest Thinnest n Bac's T17ickest Thinnest #1 Bags Bentonite/Cement Mix 3 % Mix 5 % Mix <br /> 2 . 5 5 1 5 10 1 Bentonite per 47 Ib 1 .41 2047 <br /> 5 10 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 1 25 5 25 50 5 <br /> 15 30 30 60 6 <br /> 17. 5 35 7 35 70 7 <br /> '% 0 40 40 s0 S <br /> 10/ 16 / 2017 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468 - 3420 F 209 464 - 0138 www . sicehd . com <br />