Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br /> COUNTY <br /> Greatness gross here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: R1131 V Inspector: ��iIiVNQ...5 CONSTRUCTION <br /> Facility Xdd��ress``: 2(YY) Sfit njn Ic. . <br /> Well Address: Total Depth: <br /> WP# UA'N w kclC Well#: Drilling Rig Type: (nl� <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes LINO <br /> Drilling Company: t 1 <br /> Driller Onsite: Screen Length From: 40 To: SO <br /> Consultant: 5 Filter Pack From: To: J <br /> Geologist: �lGln Bentonite From: 3G To: 32 <br /> Grout From: S2 To: O <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe Ahristie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: � height <br /> SAMPLING ABOVE-GROUND <br /> COWLS ION C TIO <br /> Holding Temperature: COMPLETION <br /> Method: °ram°Stflacr.""+ <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑NO —tt' <br /> ft. <br /> Ott. 1 <br /> SPOILS P` _ �b � �.A S'v/ <br /> a = <br /> Contamination Noted: ❑Yes ONO <br /> If yes,spoils storage Location: Monad _ 61 I� <br /> aao4on j _ B NO qA�II . <br /> Covered: El Yes ❑No _ aawPack up fo 'Sy <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: S& = TI aNsl{fUn t <br /> Snrcl 36 <br /> Depth to Water: tt. = tt. t <br /> 3'L <br /> Grout Material: 1VPt& & ..en �jQy�Oni lPi °` <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: -y�1(a,l . Casing Type: <br /> 5&ell Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity XYemie ❑Other: Type of Method: <br /> Water ment 471b Water Cement 941b <br /> allons Ba s eallons Bags <br /> Thickest Thinnest #ea Thickest Thinnest aBags B e n t o n I t of C e m e n t mtX 3%MiX 5.AiiiiX <br /> 2.5 5 1 1 s 10 1 Bentonite per 47 lb 1 1.41 2.47 <br /> s to z 10 20 2 Bentonite per 94 lb 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 3s 70 7 <br /> 20 40 8 40 1 BO 6 <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 />