Laserfiche WebLink
SAN iOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> o� ��� so� <br /> Date: � Inspector:_`�+i}q,� �,, CONSTRUCTION <br /> Facility Address: M�Jy- h 4oc� <br /> Well Address: P Total Depth: <br /> WP# ObybM,'33 Well#: to IN Drilling Rig Type: <br /> Soil Boring#: `–`L <br /> Drilling Company: y�' u �,.�(.oJ DONS UIT. Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> "A"= Screen Length From: To: <br /> Driller Onsite: <br /> Consultant:SnrcA W\S Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes qNo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ANO casing <br /> If yes, location and distance: height <br /> SAMPLING AsovE>;atxlNo <br /> Holding Temperature: CONFPLErION �LrrioN <br /> Method: Grwnd Sutacs <br /> Screening Method: grotA <br /> Verified Chain of Custody: ❑ Yes ❑No —ft. <br /> tt. <br /> it. <br /> SPOILS — <br /> o . <br /> Contamination Noted: ❑ Yes ❑No ` = r <br /> If yes,spoils storage Location: slotted <br /> Covered: ❑ Yes El No = <br /> pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 1ZIF <br /> =_ <br /> Depth to Water: A <br /> n. JL <br /> Grout Material: c <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ;; <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout Dover Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity RTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> Ilons Bas gallill ons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 55%Mix <br /> 2.5 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 1 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />