Laserfiche WebLink
SAS ,JQAQUIN Environmental Health Department <br /> —.C.O U N T Y= <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: y/2 y 17�' Inspector: �r"'V'4iE li'rt CONSTRUCTION I <br /> Fa cil ity Ad d ress: �� l <br /> Well Address: Total Depth: <br /> WP# G D gp911 Well#: Drilling Rig Type: <br /> Soil Boring#: (f - 20 " U1 Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: / LoZ 4>c <br /> Driller Onsite: /l iG Screen Length From: To: <br /> Consultant: <br /> ']A,L-� Filter Pack From: To: <br /> (�°:;�r <br /> Geolcgist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: night <br /> —awl- <br /> SAMPLING <br /> SAMPLING ABGVS-GROUND <br /> Holding Temperature: wwPLE oN �>�,�F�om <br /> r. <br /> Method: CxoundS:ataas /I, <br /> Screening Method: Grp <br /> Verified Chain of Custody: ❑ Yes ❑No f <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No r o <br /> If yes, spoils storage Location: atad <br /> sacron <br /> Covered: El Yes ❑No x <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _1L" <br /> Depth to Water: �5 fL — <br /> Grout Material: A�f�,I (.Ew 'n4 <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Weil Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity J�!Tremie ❑Other: Type of Method: <br /> WaterI Cement 471b Water Cement 941b <br /> Ilons Bas Pallons Bags <br /> Thickest Thinnest Bags Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 55% MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> r' 15 3 15 30 3 r <br /> 1 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 B <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 />