Laserfiche WebLink
SAN.tJOAQUIN <br /> N r; Environmental Health Department <br /> 1 —COUNTY-- <br /> i <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ` 121 202E Inspector: �4- CONSTRUCTION <br /> i <br /> Facility Address: Zl "-/ a> �t�/ <br /> Well Address: Total Depth: <br /> WP# (7 L4U6- Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: 4 G(7� <br /> Driller Onsite: Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: <br /> Geologist: ) .Q_rwl r4-to- 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 1:1 No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONFLE MN COMPLETION <br /> Method: Ground Surf aas <br /> Screening Method: oraut <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> tt. <br /> n. <br /> SPOILS . <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: stonad <br /> aecdon <br /> Covered: ❑ Yes ❑No 9w+Pack <br /> If yes, material: _= <br /> GROUTING or DESTRUC ION Total Depth: �5 <br /> Depth to Water: V n- n' <br /> Grout Material: N U-ti _CC).i 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'�Ioring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ravity Tremie ❑Other: Type of Method: <br /> waterement 47 b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 z 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 1 3 <br /> 10 10 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 209464-0138 1 www.s*cehd.com <br />