Laserfiche WebLink
SAN JOAQUIN <br />—COUNTY— <br />Greatness grows hire. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: \o1� �� <br />Inspector: WW <br />Facility Address: <br />To: <br />Well Address: <br />To: <br />WP# <br />Well#: <br />Soil Boring#: <br />2.5 5 <br />Drilling Company: _UX) <br />Driller Onsite: tom <br />1 <br />Consultant:5N <br />2 <br />Geologist: S <br />20 <br />2 <br />�Jtn <br />Public Water System Onsite: ❑ Yes i�No <br />Domestic Well Onsite: ❑ Yes CKINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes E] No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: U <br />Depth to Water: <br />Grout Material: &'Cm- um" f - <br />Gallons <br />"f - <br />Gallons of Grout Used: 3 <br />❑Well Installation ❑Well Destruction <br />El Boring Installation 1 Boring Destruction <br />nnFTunn I ICFn <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity kTremie ❑Other: <br />\CONSTRUCTION <br />QVow- ) <br />Total Depth: — <br />Drilling Rig Type: <br />�Xgin \"-Annular EHD Seal Verified: <br />Green ength From: <br />ElYes ❑No <br />To: <br />Filter Pack From: <br />To: <br />Bentonite From: <br />To: <br />Grout From: <br />To: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />allons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#sags <br />Thickest Thinnest <br />tlsags <br />2.5 5 <br />1 <br />5 <br />10 <br />1 <br />5 10 <br />2 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 25 <br />5 <br />25 <br />50 <br />5 <br />15 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 35 <br />7 <br />35 <br />70 <br />7 <br />20 40 <br />8 <br />40 <br />80 <br />8 <br />COMPLETION ❑ Stove Pipe El Christie Box <br />casing <br />height <br />AsovE-61ROUND c atsz-f aox <br />COWFLETION Ca WLETION <br />Ground sumace + <br />grout <br />tt. <br />ft. <br />= o <br />•farad �- — 3 <br />s+c9an <br />T,nv.t Pack <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: _ <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Gement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <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.smcehd.com <br />