Laserfiche WebLink
SANJOAQUIN <br /> Environmental Health Department <br /> �� —COUNTY <br /> i <br /> Greatness gross here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: inspector: ir1 S CONSTRUCTION <br /> Facility Ad &D Ch -y-np 4— IA.-tbt l <br /> Well Address: J Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: u D yae Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: / Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: 00(ih, Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUNO <br /> Holding Temperature: CONPLET1ON COMPLETION � <br /> Method: G=n°S <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No —tt <br /> tt. <br /> SPOILS tt. <br /> Y O <br /> Contamination Noted: ❑ Yes ❑No <br /> M• — <br /> If yes,spoils storage Location: stoned !: <br /> ' _ 8 <br /> Covered: ❑ aoc5onYes ❑No — gravel Pack <br /> If yes,material: <br /> t <br /> GROUTING or DESTRUCTION Total Depth: '2b ZLA 6 tl <br /> Depth to Water: <br /> Grout Material: W (yompyl. MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: BLS Casing Type: <br /> ❑Well Installation XWell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation El Boring Destruction <br /> 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 9tremie ❑Other: Type of Method: <br /> Water ment 47115 Water Cement 941b <br /> allons BB s gallons Belts <br /> Thickest Thinnest AB Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 5% Mix <br /> 2.5 5 1 s 10 1 Bentonite per 47lb 1.41 ' 47 <br /> 5 10 2 i0 20 z <br /> 7.5 3 15 30 3 Bentonite per 94 lb 2.82 4.7 <br /> 15 -. <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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 wivw.sicehd.com <br />