WP0040077 - Laserfiche WebLink

Home Browse Search

j�q,urn,c N� �AQ��r� Environmental Health Department �" COUNTY Greatness grows mere. q Monitoring Well/Soil Boring Inspection Report Dater 1� 1 \ Inspector: CONSTRUCTION Facility Address: Well Address: RZ_ Total Depth: SV WP# A 0 01-7 Well#: Drilling Rig Type: �I\U\b 9,TW Soil Boring#: Min 2"Annular EHD Seal Verified: Yes ❑No Drilling Company: �y��.ASiI� �Q .,�S,} ` Driller Onsite: I sz� Screen Length From: To: Consultant: Filter Pack From:z,\l To: 26Z Geologist: Bentonite From: Zc7'L To: SA��Q�� Grout From: To: Public Water System Onsite: ❑ Yes No COMPLETION ElStove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes K]No casing If yes, location and distance: f j_,F height SAMPLINGJISOVE-GiiO JND CHR__ Holding Temperature: COMPLETION CLEnON Method: Grwnd Surface Screening Method: ar«ri Verified Chain of Custody: ❑ Yes El No ft. - "— _X ;t. SPOILS Contamination Noted: ❑ Yes ❑No If yes, spoils storage Location: sstJen is Covered: ❑ Yes El No If yes, material: GROUTING or DESTRUCTION Total Depth: �`` A =_ Depth to Water: IF ft. Grout Material: Gallons of Grout Used: MATERIALS DEVELOPMENT a Casing Type: �7Well Installation ❑Well Destruction Blank Feet Screen Feet ❑Boring Installation ❑ Slot Size: Boring Destruction Bags Size: Cement: METHOD USED Bags Sand/Gravel: ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: Filter Pack Type/Size: ❑ Gravity 19Tremie ❑Other: Type of Method: Water Cement 471b Water Cement 94 lb allons Bas gallons Bags Thickest Thinnest :1 Bags Thickest Thinnest .Bags Bentonite/Cement Mix 3% Mix 5%Mix 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 5 10 z 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 1 25 5 25 50 5 15 30 6 30 60 6 17.5 35 7 35 70 7 20 40 8 40 80 8 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com