Laserfiche WebLink
f z'° r SAN J OAQ U I N Environmental Health Department <br /> 1" ! L COU NTY — <br /> :°gc�Foa� P/ Greatness grows here . <br /> Monitoring Well /Soil Boring Inspection Report <br /> Date : Inspector : At* a r?n` CONSTRUCTION <br /> Facility Address : 81i S wovsd � C.✓u <br /> Well Address : 1 Total Depth : <br /> WP# 2J3Z Well # : W ,/ it*) .3 Drilling Rig Type : <br /> Soil Boring# : <br /> Min 2" Annular EHD Seal Verified : [I Yes El No <br /> Drilling Company : 2l- <br /> Driller Onsite : .124 5leid Screen Length From : To : <br /> Consultant : /� ,��' E Filter Pack From : To : <br /> Bentonite From : To : <br /> Geologist : /P7 ,0X <br /> Grout From : To : <br /> Public Water System Onsite : ❑ Yes 11 No COMPLETION ❑ Stove Pipe ❑ Christie Box <br /> Domestic Well Onsite : ❑ Yes ❑ No casing <br /> If yes, location and distance : height <br /> SAMPLING asove-caoUNo <br /> Holding Temperature : COWPLErION cOMPPLETION <br /> Method : G=nd Smiacs <br /> Screening Method : grout <br /> Verified Chain of Custody : ❑ Yes El No 0 � ft. <br /> fto <br /> n. <br /> SPOILS Y <br /> Contamination Noted : ❑ Yes [] No <br /> If yes , spoils storage Location : . lon2d42 <br /> sacdon y' "— <br /> Covered : ❑ Yes ❑ No = 9i pack <br /> If yes, material : <br /> GROUTING or DESTRUCTION Total Depth : IF <br /> Depth to Water : tt tt. <br /> Grout Material : rC <br /> MATERIALS/ DEVELOPMENT <br /> Gallons of Grout Used : <br /> Casing Type : <br /> ❑ Well Installation ER Veil Destruction Blank Feet Screen Feet <br /> Slot Size : <br /> ❑ Boring Installation ❑ Boring Destruction Bags iz Cement : <br /> METHOD USED Bags Sand/Gravel : <br /> Type/ Brand of Bentonite : <br /> ❑ Pressure Grouter❑ Over Drill Filter Pack Type/Size : <br /> El Gravity L( I remie ❑ Other : Type of Method : <br /> Water Cement 471ba er ment 941b <br /> ailons Rallons Bags <br /> Thickest Thinnest # Bags Thic est Thinnest # Bags Bentonite/Cement Mix 3 % Mix 5 % Mix <br /> 2s 5 1 5 10 1 Bentonite per 47 Ib 1 .41 2 .47 <br /> 5 10 2 10 20 1 2 Bentonite per 94 Ib 2082 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 8 40 80 8 <br /> ) ✓ 10/ 16/2017 <br /> 1868 E . Hazelton Avenue Stockton , CSI o n' is 9265 I T 209 468- 3420 1 F 209464- 0138 www , sicehd . com <br />