SU0012665 - Laserfiche WebLink

Home Browse Search

"' SAN 10AQUIN Environmental Health Department ;a r!t j.G _...._.COUNTY P r� '•° ureotness grows her.. Monitoring Well/Soil Boring Inspection Report Date: ��A✓ Inspec r: it CONSTRUCTION Facility Address: Well Address: Total Depth:— r I WP# " W II#: Drilling Rig Type: yc i S-t��ti l t �t Soil Boring#: �� Drilling Company: Min 2" Annular EHD Seal Verified: 11 Yes f_1 No .1 � _ Driller Onsite: C� Screen Length From: To: Consultant: J C"; r Filter Pack From: To: _ C�-Z• Geologist: isr '� J C t S 5 (; Bentonite From: To: Grout From: To: Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes ❑No casing if yes, location and distance: height iii SAMPLING ABOVE—GROUND CHRZ _ . Holding Temperature: CONFLETfON CCOKUN_ETION Method: Ground Surface Screening Method: arm Verified Chain of Custody: ❑ Yes ❑No —h' ft. ft. SPOILS Contamination Noted: ❑ Yes ❑No If yes, spoils storage Location: clod .on Covered: Covered: ❑ Yes ❑No = a If yes, material: GROUTING or DESTRUCTION Total Depth:_ 9 __ Depth to Water: IV jpf IFn - IF tt' Grout Material: int• � �(,� MATERIALS/DEVELOPMENT Gallons of Grout Used: Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet ❑Boring Installation Boring Destruction Slot Size: J� Bags of Cement: METHOD USED Bags Sand/Gravel: Type/Brand of Bentonite: ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: 3ravity ❑Tremie ❑Other: Type of Method: Water Cement 471b Water Cement 94 lb gallons Bas gallons Bags Thickest Thinnest 4Bags Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix]5%Mix 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.412.47 5 1 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 7.5 15 3 15 30 3 10 20 20 40 4 12.5 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 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.coni