Laserfiche WebLink
SAN )OAQ U I N Environmental Health Department <br /> —COUNTY <br /> r.. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: �r CONSTRUCTION <br /> Facility Address: , <br /> f6 <br /> Well Address: Total Depth: <br /> WP# DD ,wb Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: *-A, � Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Screen Length From: To: <br /> Driller Onsite: Filter Pack From: To: <br /> Consultant: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND cHR__ <br /> Holding Temperature: COMPLE ;ON ccwLEnON <br /> Method: Ground Sumacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No ' <br /> n. <br /> —ft. <br /> SPOILS = <br /> _ _ o <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes, spoils storage Location: 310a2d = - <br /> sac9on _ _ <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: (Q0-E? -_ <br /> Depth to Water: n• tt' <br /> Grout Material: o , 5.•• <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> � Casing Type: <br /> W' ell Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation []Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> []PressureGrout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity �emie ❑Other: Type of Method: <br /> Water Cement 47 lb Water Cement 941b <br /> allons Bas Rallans Bags <br /> Thickest Thinnest ttBags Thickest Thinnest bBags 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 1 60 6 <br /> 17.5 35 7 P40 <br /> 5 70 7 <br /> 20 40 8 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.socehd.com <br />