Laserfiche WebLink
OWN <br /> . SAN l 0 A Q U I N <br /> Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> n Monitoring/ Well/Soil Boring Inspection Report <br /> 1. 7 <br /> Date: Inspector IA 1T"r»/2)'4.la CONSTRUCTION <br /> Facility Address:_1 13 Al. L o h <br /> Well Address: Total Depth: nn �,/ <br /> WP# .503 Well#: Drilling Rig Type: HSA f av- Q <br /> Soil Boring#: g2 Min 2" Annular EHD Seal Verified: ❑ Yes []No <br /> Drilling Company: r-ACo/1 <br /> Driller Onsite: �3 �Qi►' Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 0 N COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: COLFLEWN �FrtoN <br /> Method: Ground Sudwe <br /> Screening Method: or�- <br /> Verified Chain of Custody: El Yes El No M <br /> tt. <br /> ft. <br /> SPOILS Yr <br /> Contamination Noted: ❑ Yes []No ` <br /> x _ <br /> If yes, spoils storage Location: atoned ._ 3 <br /> section <br /> Covered: ❑ Yes ❑No = ¢ate tack <br /> If yes, material: 1 <br /> GROUTING or DESTRUCTION Total Depth: I S I CX 2) 4• =_ <br /> Depth to Water: 0. M <br /> Grout Material: P,a aw-Lp/ft <br /> Gallons of Grout Used: a MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation TABoring 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 /> 9 Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 71b Water Cement 941b <br /> allons Bas Rallons Bags <br /> Thickest Thinnest »Bags Thickest Thinnest 7t Bags Bentonite/Cement 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 /> 61 'Z'& 9`'( S q 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.sicehd.com <br />