Laserfiche WebLink
UIN <br /> \, r. . , ,� Environmental Health Department <br /> LTA COUNTY— <br /> oSr. Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ��� Inspector: fl`�`t'�� �' CONSTRUCTION <br /> Facility Address: Vtk° VJ \U� <br /> Well Address: Total Depth: <br /> WP# 01\ \," Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: `CAls'�_ Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes EJ No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION cp�TnoN <br /> Method: Gr xmd Sudacs <br /> Screening Method: araut <br /> Verified Chain of Custody: ❑ Yes El No <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No _ <br /> If yes,spoils storage Location: <br /> sr:•cn x' — � <br /> Covered: ❑ Yes F1 No <br /> 1-ve,was <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: � �� �� <br /> Depth to Water: _ <br /> Grout Material: kA�< <,`�y4Ny MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen _Feet <br /> ❑ Slot Size: <br /> Boring Installation Loring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Ov#r Drill Type/Brand of Bentonite: <br /> is k. ���k Filter Pack Type/Size: <br /> Gravity IdTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas allons Bags <br /> Thickest Thinnest .1 Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 3% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 I 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 - 35 70 7 <br /> 20 40 2 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />