WP0039011 - Laserfiche WebLink

Home Browse Search

SAN 10AQ U I N Environmental Health Department -- COUNTY---- {{ l Monitoring Well/Soil Boring Inspection Report Date: l l Inspector: iV ltl7�Vt fd�/0� CONSTRUCTION �Qyl 1�0Oq I J Facility Address:�► ► _' A VIL Well Address: I otal Depth: WP# o t Well#: Drilling Rig Type: Soil Boring#: =PT t Min 2" Annular EHD Seal Verified: ❑ Yes 11 No i Drilling Company: Qo S_6``� Driller Onsite: vi I e / Screen Length From: To: Consultant: I I a Ce_ u Filter Pack From: To: Geologist: IR p Bentonite From: To: Grout From: To: Public Water System Onsite: ❑ Yes 11 No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes ❑No casing If yes, location and distance: WT height SAMPLING ABOVE-GROUND Holding Temperature: cO s�rloN cC_oMPL—BOX Method: Ground Strfaca "'+ Screening Method: ar�,t Verified Chain of Custody: ❑ Yes ❑No ft. ft. ft. SPOILS — Contamination Noted: ❑ Yes ❑No = If yes, spoils storage Location: plod Covered: ❑ Yes ❑No g-vol Pack If yes, material: ��nn GROUTING or DESTRUCTION Total Depth:�ocU P�. Depth to Water: �J +, �`� ft• ft Grout Material: UweM MATERIALS/DEVELOPMENT Gallons of Grout Used: Lf 4ualtpy) Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet ❑Boring Installation Loring Destruction Slot Size: i� Bags of Cement: METHOD USED aNnk 2 Bags Sand/Gravel: Type/Brand of Bentonite: ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: ❑ Gravity fKTremie ❑Other: Type of Method: Water Cement 471b Water Cement 941h allons Bas Qallons Baas Thickest Thinnest uBags Thickest Thinnest ^"Bags Bentonite/Gement Mix 3% Mix 5% Mix 2.5 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 7.5 15 3 15 30 3 10 20 4 20 40 4 12.5 25 5 25 s0 5 15 30 6 30 60 6 17.5 35 7 35 70 20 40 a 40 00 s 0J QL(�A 6 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com