Laserfiche WebLink
JOAQUIN <br />SANEnvironmental Health Department <br />—COUUNTY—NTY--- <br />- <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /15nspe tor: WL CONSTRUCTION <br />Facility Address: { k 'j ✓V) <br />Well Addrss: <br />a <br />Total Depth: <br />� / I <br />'���}-�� S�►lt <br />WP# VjIX1 <br />Soil Boring#: <br />W II#: <br />Drilling Rig Type: <br />N <br />h � <br />2.5 5 <br />Drilling Company: <br />ay n j <br />Min 2" Annular EHD <br />Seal Verified: ❑Yes ❑No <br />Driller Onsite: <br />,n fi rz' S)Screen <br />Length <br />From: To: <br />Consultant:) <br />15 30 <br />Filter Pack <br />From: To: <br />Geologist: <br />V <br />Bentonite <br />From: To: <br />5 <br />25 50 <br />Grout <br />From: To: <br />Public Water System Onsite <br />Domestic Well Onsite <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />casing <br />height <br />ABOVE -GROUND CF�ilS7Y SOX <br />COMPLETION COMPLETION <br />Ground Surtan <br />grout <br />ft. <br />ft. <br />ft. <br />— o I <br />abttad = � <br />=. _ Givnl Pacsc <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: ►J J NJ", <br />Grout Material: ' �tr`,V, j ATERIALS/DEVELOPMENT <br />Gallons of Grout Used: <br />Casing Type: <br />❑Well Installation ❑Well Destruction V V (i P Q Blank Feet <br />V �l Slot Size: <br />❑Boring Installation 10Boring Destruction <br />10 <br />/' of Cement: <br />METHOD USED P� bi�'�`j Bags Sand/Gravel: <br />S+ Type/Brand of Bentonite: <br />❑Pressure Grout ❑Over Drill <br />Filter Pack Type/Size: <br />Gravity ❑Trernie ❑Other: Type of Method: _ <br />Water <br />allons <br />Cement 47 lb <br />Bas <br />Water <br />gall ons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />r Bags <br />Thickest Thinnest <br />.1 Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 j <br />0 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />6 <br />30 1 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 4P <br />8 <br />40 1 80 <br />8 <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.411 2.47 <br />Bentonite per 94 Ib 2.821 4.7 <br />y— • � 10/16/2017 <br />((] <br />HaGlJ G�°'oj 3 YYl <br />1868 E. zelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sicehd.com <br />