Laserfiche WebLink
a � SAN,IOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness <br /> OUNTY— <br /> Greatness grows here <br /> �n Monitoring Well/Soil Boring Inspection Report <br /> Date:�lJ� Inspector:�n CONSTRUCTION <br /> Facility Ad�d'r-e-'s-s::�\ {� 7TUU 11 <br /> Well Address: Total Depth: <br /> WP# D WAM Z Well#: Drilling Rig Type: <br /> Soil Boring#: Z 6tq, Min 2"Annular EHD Seal Verified: ❑ Yes []No Company: &7e') EF)( . 5010sk Y'��2 OU01�(`d►1 <br /> Driller Onsite: C 6pls �XaYL-C"105 Screen Length From: To: <br /> Consultant: <br /> Filter Pack From: To: <br /> C�.V�,nd,� '�,P.uv►.l irW Bentonite From: To: <br /> Geologist: �Gp • <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: CONFLErJON C� _tPLEnoN <br /> Method: around Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No <br /> tt. <br /> tt. <br /> SPOILS = <br /> — - o <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: slotted <br /> sacdon <br /> Covered: ❑ Yes ❑No <br /> gravol pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:�� . =_ <br /> Depth to Water: n n <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well 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 XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eall ons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest VBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonfte per 47 Ib 1 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 1 2.821 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 20 40 4 <br /> 12.5 25 r5 j 25 50 5 <br /> 15 30 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.secehd.com <br />