Laserfiche WebLink
�8 &J]�&�UU&| <br /> J��������W�� . Env' nNMente" ^'lealth Department <br /> MUn'f0r'Dg Well/Soil Boring Inspection Report <br /> Date: Inspector: L-1-1 Y�—� CONSTRUCTION <br /> . <br /> ll <br /> ,,="",.=". u Total Depth: <br /> ,, Drilling Rig Type: <br /> Drilling ' ' ~ Min Z"Annular EHDSeal Verified: [] Yes []No <br /> Driller Onsite: - ~ Screen Length From: To:_________ <br /> Consultant: Filter Pack From:_______ To:_�________ <br /> Geologist: y,A' � Bentonite From: To: <br /> ���` <br /> Grout - Frum: To:__________ <br /> Public Water System Onsite: []Yes ONo <br /> COMPLETION LJStove Pipe []Christie Box <br /> Domestic Well Onsite: []Yes EINo <br /> oa*;Lng <br /> ifyes,location and distance: ' ' heJsht ' <br /> S�x�zIuG <br /> ^u,o o . <br /> Holding Temperature: ooP,,Pisrx0m <br /> COMPLETION <br /> Method' oni"mo*«=" ' <br /> Screening Method: T <br /> Verified Chain ofCustody: []Yes []No <br /> SPOILS ^~ <br /> Contamination Noted: []Yes []No <br /> |fyes,spoils storage Location: � <br /> mnned � <br /> Covered: []Yes []No | <br /> if yes, material: ~- <br /> GROUTING or DESTRUCTION Total Depth: <br /> DepthtoWater: <br /> Grout Material: <br /> Gallons nfGrout Use <br /> _� ���------- �a�in�Type� <br /> L�VVe|| Installation [].VVe|/ Destruct�un B/ank__________Feet Screen Feet <br /> ��� Slot Size: <br /> []BurinQ|nsta||ation ��"vhnXDestruction � <br /> Bags ofCement: <br /> METHOD USED Ba8s3and/Grave|: <br /> []pressureGrout []OverDrU| Type/Brand ofBentonite: <br /> � <br /> , FUType/ <br /> Size: <br /> Q3��ravI t []Tremie ' []Other: Type ofMethod' <br /> Water —T-� -�nI4711 Water :!ement94lb <br /> ThIckest Thinnest 4 Bags T ickest2 'Minlest 4 Bags Bentonite/Cement Mix 3%Mix 5%Mix <br /> 2.5 s 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 2.82 <br /> 7.5 15 —3 30 3 Sentonite per 94 lb 4.7 <br /> 20 40 4 <br /> 10 20 4 <br /> 20 40 8 40 8 <br /> 10/16/2017 ' <br /> 1868E. Hazelton Avenue Stockton, California Q52U5 / T 209468'3420 / F 209 464-0138 1 <br />