Laserfiche WebLink
F" SANeJ0AUUIN <br /> Environmental Health Department <br /> _ Cream_ss Grows :fere. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: CONSTRUCTION T <br /> Facility Address: —1--p W N („'/r—&,.%- <br /> Well Address: Total Depth: <br /> WP# 0c)3 gS" Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: ttWr.. � <br /> Driller Onsite: Cot ../ Screen Length From: To: <br /> Consultant: <br /> Filter Pack From: To: <br /> Geologist: 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 casing <br /> If yes, location and distance: haLgnt ; <br /> SAMPLING ,Wvt-6R0U D <br /> Holding Temperature: COINP L71ON c WLETjON <br /> Method: C3rvind Sulwo <br /> Screening Method: erg <br /> Verified Chain of Custody: ❑ Yes ❑Noy' <br /> ft. <br /> SPOILS r,F <br /> Contamination Noted: ❑ Yes ❑No = e <br /> If yes, spoils storage Location: <br /> sa <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: SO_(L_ r <br /> Depth to Water: o - — Y' <br /> Grout Material: 10� 3, Sa,t,I,C- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> �� Casing Type: <br /> N? ell Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑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 1YT`re_mie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Fall ons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest ti Bags Bentonite/Cement Mix 3% Miff 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10' 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7,5 15 3 15 30 3 i <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, California 95205 1 T 209 468-34201 F 209 464-0138 1 wvvw.sicehd.com <br />