Laserfiche WebLink
? c° SKJOAQUIN <br /> Environmental Health Department <br /> COUNTY -- <br /> e,�_mer <br /> �9t,�F�a Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:fI, Inspector: CONSTRUCTION <br /> Facility Address: i��,l; <br /> Well Address: N Total Depth: <br /> WP# Well#: Drilling Rig Type:matin . �t��3,�-"► <br /> Soil Boring#: <br /> Drilling Company: ��NNC,.� �S �i` �^Min 2"Annular EHD Seal Verified: El Yes El No <br /> ���' <br /> Driller Onsite: Screen Length From: To: <br /> ✓LF�ip \�`A�•�W � �\Sr"I� <br /> Consultant: Filter Pack From: To: %� ' <br /> Geologist: Bentonite From:2,J,, <br /> �I Grout From: To: <br /> Public Water System Onsite: El Yes LWNo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ANo casing <br /> If yes, location and distance: height <br /> iii <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLfiTION SON <br /> Method: G=nd Suiacn <br /> Screening Method: 9rcut <br /> Verified Chain of Custody: ❑ Yes El No M <br /> it. <br /> it. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes 11 No _ <br /> If yes, spoils storage Location: allotted c' <br /> aKJan = B <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> ROUTI r DESTRUCTION Total Depth: " =_ <br /> Dept o Vater: n- — n- <br /> Grout Material: a �1��n1� r\�( -LZ' I ���\ MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: til ,Z_"\ 2 b <br /> l4lWell Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> 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 ITremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest VBags I Thickest Thinnest VBags 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 z 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 1205 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.s*cehd.com <br />