Laserfiche WebLink
SAN JOAQUIN <br />r- Environmental Health Department <br />—COUNTY— <br />' �,.��` Grratness grow,; <br />Monitoring Well/Soil Boring Inspection Report <br />Date:%/y I Inspector:< <<<� <br />Facility Address: / 24 2ol <br />Well Address: <br />WP# JD .3sKV 97 Well#: <br />Soil Boring#: _a�0 2, 3 <br />Drilling Company: ja !.v <br />Driller Onsite: <br />Consultant: vif4/l��i �=k01 <br />Geologist:; <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes 11 No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />Public Water System Onsite: ❑ Yes []No COMPLETION ❑ Stove Pipe ❑Christie Box <br />Domestic Well Onsite: ❑ Yes ❑No <br />If yes, location and distance: <br />Ow'W".101MA <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 />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTIO Total Depth: 1J <br />Depth to Water: <br />Grout Material: ~ <br />(1 Ceoew <br />Gallons of Grout Used: <br />❑Well Installation []Well Destruction <br />❑Boring Installation RBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity ❑Tremie AOthet47–p' "ifl <br />eq -ate, <br />allorus/ <br />a nt 47 <br />water <br />izallons <br />Cement 941b <br />Bags <br />Thic est Thinnest <br />zBags <br />Thickest Thinnest <br />4Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />110 <br />20 <br />7.5 15 <br />3 1 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />so <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />17.5 1 35 <br />7 <br />35 70 <br />7 <br />20 1 40 <br />8 <br />4G 80 <br />e <br />cae Ing <br />height <br />ABOVE -GROUND CHRLSTY-Box <br />C WLEr10N CCMPLETICN <br />Smund Suiac• <br />or«n <br />n. <br />tt. <br />T <br />•bttad = � <br />it cn — <br />—ft. = n. <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/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />-5– 10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />