Laserfiche WebLink
kauiH' <br /> SANsJ0AQUIN Environmental Health Department <br /> COUNTY— <br /> cq` P Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: i Inspector: Ion h C4 CONSTRUCTION <br /> Facility Address: Pe t4 <br /> Well Address: M Total Depth: <br /> WP# ')C) Well#: �-�` Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: Gt ' Y <br /> Driller Onsite: `d-�r Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: � `g`T Bentonite From: To: <br /> 6 Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No 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: COWLETION COMPLEnON <br /> Method: Ground Suriacn <br /> Screening Method: VZAGrout <br /> Verified Chain of Custody: El Yes El No ft. <br /> n. <br /> —ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: slonad = 8 <br /> axon <br /> Covered: ❑ Yes ❑No g-vlw padc <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water ` HS< n• 1. <br /> Grout Material- <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation Aoring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED �' �,� Bags Sand/Gravel: <br /> ,/ Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Ulr <br /> Filter Pack Type/Size: <br /> ❑ Gravity --skemie ❑Other: Type of Method: <br /> Water ����/Ce``"`ment 471b Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest uBags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2. 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 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 s 40 80 8- <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s*cehd.com <br />