Laserfiche WebLink
SAK JOAQUIN Environmental Health Department <br /> —COUNTY <br /> 1, Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: � I Inspector: 1:� CONSTRUCTION <br /> Facility Address: Yl <br /> Well Address: Total Depth: <br /> WP# ©U-1 0 0 Well#: Drilling Rig Type: <br /> Soil Boring#: Ly <br /> Drilling Company: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: lni Screen Length From: To: <br /> Consultant: MAiyl Filter Pack From: To: <br /> Geologist: al,\11vt,, <br /> 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 El No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: cANFLETION COMPLETION <br /> Method: Ground Surface <br /> 1021 <br /> Screening Method: groutVerified Chain of Custody: ❑ Yes E]No —` n' <br /> it. <br /> SPOILS ,. <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: slotted <br /> soon <br /> Covered: ❑ Yes ❑No = gravel <br /> Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 3l�l • <br /> Depth to Water: — fL 2F IF <br /> n' <br /> Grout Material: tc MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation'"BSlot Size: <br /> '"Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity `(aremie ❑Other: Type of Method: <br /> Water Ceme t 47Ili' Water Cement 941b <br /> gallons Bas gallill ons Bags <br /> Thickest Thinnest pBags Thickest Thinnest ttBags Bentonite/Cement Mix 3% MIX 5% MIX <br /> 2.5 5 1, - 5 10 1 Bentonite per 47 Ib 1 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 1 2.821 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 7 35 70 7 <br /> 20 40 8 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.sicehd.com <br />