Laserfiche WebLink
SAN.<>JOAQUIN <br /> Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �° d / Inspector: ,/ CONSTRUCTION <br /> Facility Address: Wc.si' Lod, <br /> Well Address: Total Depth: <br /> WP# 003WI-1 Well#: Drilling Rig Type: <br /> Soil Boring#: 01 Sys Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: V U Drvl 1./X Screen Length From: To: <br /> Driller Onsite: IE_9 •—a <br /> Consultant: W, �,c�ku k) <br /> Filter Pack From: To: <br /> Geologist: =job Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No T_ casing <br /> If yes, location and distance: ♦ height <br /> SAMPLING ABCVE4GR0UND <br /> Holding Temperature: CO1ON COMPLE onxt <br /> Method: °rx"''nd Suriaca '+ <br /> Screening Method- e� <br /> Verified Chain of Custody: ❑ Yes ❑No ft- <br /> ft. <br /> fi. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes, spoils storage Location: slarod <br /> sr_ on t� — <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: tS — <br /> Depth to Water: o - 'FIF <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:-1i$'c <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation oring 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 /> LoGravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas 12all ons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags Bentonite/Gement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10' 2 10 20 2 Bentonite per 94 Ib 2.82 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 I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.slcehd.com <br />