Laserfiche WebLink
SAN 10AQUIN <br /> ff� Environmeri,tal Health Department <br /> 1 COUNTY - <br /> •cc,RbaNiP' Gieotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: \k U Inspector: CONSTRUCTION <br /> Facility A dress: 1.��1��`� ��i✓L (iU�'�nQi/ IG(F1i� <br /> V'Jcll Address: _ _ Total Depth: <br /> WP# 0t3 -1 \ U Well#: "`��� wU HDrilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: cj-�) SlaV tte(�. 7lC, <br /> Driller Onsite: `j Screen Length From: To: <br /> Consultant: � Filter Pack From: To: <br /> Geologist: � Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 0 N COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> ABOVEGROUND <br /> SAMPLING N ift• ckwtsn,-aox <br /> Holding Temperature: coWPLn°N COMPLETION <br /> Method: Ground Surlace <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes [I No -�--n' <br /> n. <br /> SPOILS No lJ1�eYoUr� �` n H <br /> 0 <br /> Contamination Noted: ❑ Yes ©No <br /> If yes,spoils storage Location: V vY ��yDi 1(�t slotted <br /> SrCJv- rC &*cion = B <br /> Covered: b W-Yes ❑No S�}1 I _ g-vlw Pack <br /> If yes material: -ie7 <br /> 9vldjk wt kA Al i <br /> GROUTING or DESTRUCTION Total Depth: �x `5 t4W,r✓ ""' <br /> Depth to Water: n' <br /> Grout Material: t1 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ^' Ck OL <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction <br /> Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation [Boring 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 /> ❑ Gravity ATremie ❑Other: Type of Method: <br /> Water Cement 47 lb water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest 11 Bags 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 2 10 20 2 Bentonite per 94 Ib 2.82 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 t 30 6 30 60 6 <br /> 17.5 1 35 7 35 70 7 <br /> 20 1 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.s'cehd.com <br />