Laserfiche WebLink
i <br /> SAN JOAQUIN Environmental Health Department <br /> --COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> S0.\� CONSTRUCTION <br /> Date: n 16 ZZ inspefjtor:����� <br /> Facility Acl ress: `*641 t'rtit.��tr, w' Total Depth: <br /> Well Address: Drilling Rig Type: <br /> WP# bbli RI�' Well#: <br /> Soil Boring#: A 5 _ Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: �� �� �P Screen Length From: To <br /> Driller Onsite: F1rlroln Filter Pack From: To: <br /> Consultant: To: <br /> w Bentonite From: <br /> Geologist: 1 Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes ❑No casing <br /> height <br /> ;7- <br /> If yes,location and distance: W <br /> AMV112rGROUND cr MM-8ox <br /> SAMPLING CONFLE ION COMPLETION <br /> Holding Temperature: Gosund suiac• — <br /> Method: grout <br /> Screening Method: It. <br /> n <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> SPOILS � a <br /> Contamination Noted: ❑ Yes ❑NoFE <br /> �• = o <br /> ty <br /> If yes,spoils storage Location: 4106d "M = B <br /> µcoon RI <br /> Covered: ❑Yes ❑No 9ras°I p° <br /> If yes,material: 1 =_ <br /> GROUTING or DESTRUCTION Total Depth: U tt = tt. <br /> Depth to Water: <br /> Grout Material: ►^Pat e1JL♦ MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 1 80 Casing Type: <br /> Blank Feet Screen Feet <br /> ell Installation ❑Well Destruction Slot Size: <br /> El Boring InstallationlgBoring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> Type of Method: <br /> ❑ Gravity 0Iremie ❑Other: <br /> Water ement 471b Water cement941b <br /> Ba s a llons ea s <br /> allons Thin 4Ba s BentonitelCement Mix 3%Mix 5%Mix <br /> Thickest Thinnest a Thickest nest e - Bentonite per 47 Ib 1.41 2.47 <br /> 1 5 10 <br /> 5 5 10 30 20 12.82 4.7 <br /> 2 2 Bentonite per 94 tb <br /> 5 y <br /> 3 15 30 3 <br /> 10 25 20 4 20 40 4 <br /> 1 <br /> 12.5 25 5 25 50 5 <br /> 6 30 60 6 <br /> 15 3U 35 70 7 <br /> 17.5 35 7 40 BO 3 <br /> 20 40 3 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />