WP0039011 - Laserfiche WebLink

Home Browse Search

/ :---FMI•% JHI14JUAYU111 Environunental Health Department —CC)UNTY— taY Greatness grows here. Monitoring Well/Soil Boring Inspection Report Date: I U I Q Ins ector: 1 P)S 0 CONSTRUCTION Facility Address: � �sL Aja. S i��kiviJ Well Address: Total Depth: WP# qs-4*Well#: Drilling Rig Type: Soil Boring#: P, —13— 00 —I — DO �` Min 2"Annular EHD Seal Verified: El Yes ❑No Drilling Company: Driller Onsite: Screen Length From: To: Consultant: 'A ate I< Ukl Filter Pack From: To: Geologist: YS�a Bentonite From: To: � S Grout From: To: Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: El Yes ❑No casing - If yes, location and distance: height T SAMPLING ABCV=E-&.k0UND _ Holding Temperature: CowL–mmoN COt,R• LEIioN Method: Cra,nasulaos + Screening Method: grout Verified Chain of Custody: ❑ Yes ❑Non 8. SPOILS ��,.= - it. Contamination Noted: ❑ Yes ❑No = n If yes,spoils storage Location: aa On = 2 Covered: ❑ Yes ❑No — u-vpi pack If yes, material: GROUTING or DESTRU TION Total Depth: Depth to Water: �$ 't — ' Grout Material: Gallons of Grout Used: `' S MATERIALS/DEVELOPMENT Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet ' Slot Size: ❑Boring Installation /Boring Destruction Bags iz Cement: METHOD USED Bags Sand/Gravel: ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: Filter Pack Type/Size: ❑ Gravity AuTremle ❑Other: Type of Method: Water Cement 471b Water Cement 94 lb allons Bags Rall ons Bags Thickest Thinnest ttBags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 7.5 15 3 15 30 3 10 20 4 20 40 4 12.5 25 5 25 50 5 s 15 30 6 30 60 6 C+ `�o1'p/ f 1 v 17.5 35 7 35 70 7 20 40 8 40 80 8 10/16/2017 1388 E. Hazelton Avenue I Stockton Ca6famia 95205 ( 7 20946&34201 F 20944-3138, 1 www.sicehd.com