Laserfiche WebLink
ppVlly <br /> SAN JOAQUIN Environmental Health Department <br /> COUNTY— <br /> Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �'9'z� Inspector: CONSTRUCTION <br /> Facility Address: 4d <br /> Well Address: Total Depth: <br /> WP#AoYZ Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: (ace- Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> DrillerCinsite: j,1(-rrfr Screen Length From: To: <br /> Consultant: TV"b> Filter Pack From: To: <br /> Geologist:_ re(j-x Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ONO —r casing <br /> If yes,location and distance: height <br /> SAMPLING ASOVE-GROUND <br /> I:UNPLETION COMPLETION <br /> Holding Temperature: cot.IPlErtoN <br /> Method: om"n°s"1°" 7—�— <br /> Screening Method: Grout <br /> Verified Chain of Custody: ❑ Yes ❑Nott• <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No $VE�Z� ,r <br /> If yes,spoils storage Location: SV—/ 9 <br /> .Ionaa 1 — <br /> Covered: ❑Yes ❑N6'Q S <br /> a•vWpack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: tt. — �ft. <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water a lb Water Cement 941b <br /> allons Bags gallons Bags _ <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags _ Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per47lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.821 4.7 <br /> 7.5 15 3 15 30 3 r <br /> 10 20 4 20 40 4 60 <br /> r <br /> 12.5 25 5 25 so s AN /�.6Av1L NG(� � a''�{4/ a /S <br /> 17.5 35 7 35 70 T <br /> 20 40 6 40 BO 8 'v <br /> ' 20 ^l�h /✓N • /Q / 0� Z g "/7&-r✓S ao 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 />