Laserfiche WebLink
SAN_JOAQUIN <br /> Environmental Health Department <br /> —COUNTY— <br /> ML , <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: � CONSTRUCTION <br /> Facility Address: ?`j�S M VD`3 L\ 9 <br /> I �wl <br /> Well Address:_ Total Depth: <br /> WP# O[)LO� Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: y� '��,.��� Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: T _A75Filter Pack From: To: <br /> Geologist: `tpy Bentonite From: To: <br /> Tom__ Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONFLETION COMP ELETION <br /> Method: Gewne Surtact <br /> Screening Method: gro«n <br /> Verified Chain of Custody: ❑ Yes El No <br /> it. <br /> it. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes El No = <br /> If yes, spoils storage Location: atonae <br /> &*Cion — <br /> Covered: ❑ Yes El No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _ <br /> Depth to Water: tt. <br /> Grout Material: ne�� ['�rv�i�� • <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> _ J Casing Type: <br /> ❑Well Installation ❑Well Destruction '� Blank Feet Screen Feet <br /> .5pf�\[ Ya% <br /> El Boring Installation 17 Boring Destruction ,r\� � Slot Size: <br /> L "�7 Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> 1� Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest tt Bags Thickest Thinnest b Bags 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 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 B 40 BO 1 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.s'cehd.com <br />