Laserfiche WebLink
SAN JOAQUIN Environmental Health Department <br /> COUNTY_.___. <br /> P� Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: `'� U -t Inspector: CONSTRUCTION <br /> Ci <br /> Facility Address: t>Q2 ZV1 1 Nf(Ak4J tt�`1y ti's 6 HS-A <br /> Well Address: Total Depth: <br /> WP# 001 00 Well#: Drilling Rig Type: <br /> Soil Boring#: 2 Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: �1f f'Qq JUp i!�1 <br /> Driller Onsite: (fittl�� , �� Screen Length From: To: <br /> Consultant: • r Bentonite From: To: <br /> Filter Pack From: To: <br /> � <br /> Geologist: > &dt <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes EJ No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CON'�jON COti1PLEnON <br /> Method: Ground Suria" <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes F-1 No i--n' <br /> ft. <br /> tt. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: - <br /> a .on —" <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> Ea <br /> GROUTING or DESTRUCTION Total Depth:Ed ( �� : • __ <br /> Depth to Water: n- tt. <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Yoring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity .VTremie ❑Other: Type of Method: <br /> water C mens 471 Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest bBags Bentonite/Cement Mix 3% MIX 5% MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 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 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 11 40 1 80 8 <br /> 12�q cl, Vv' 5-�g4kUt-j W� � Ia.�� 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stto_ckton, California 95205 1 T 209 468-3420 1 F (2/09 464-0138 1 www.socehd.com <br />