Laserfiche WebLink
f-` SAN :10AQ U I N Environmental Health Department <br /> COUNTY= <br /> Cii is grows Farre. <br /> ii Monitoring Well/Soil Boring Inspection Report <br /> Date: �` a 2021 Ins ector: LI SQ CONSTRUCTION <br /> Facility Address: ljtL �I(V ori" \N(w <br /> Well Addres : 412 ftuoorf Ackq Total Depth: <br /> 0 <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: - Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: N1 Tn Screen Length From: To: <br /> Driller Onsite: man 1i <br /> Consultant: Filter Pack From: To: <br /> Geologist:, . 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 ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING <br /> Holding Temperature: CONFLETION COMPLETION <br /> Method: Ground 5ulaca <br /> Screening Method: groat <br /> Verified Chain of Custody: ❑ Yes El No <br /> ts. <br /> tt. <br /> SPOILS _ <br /> 'w o <br /> Contamination Noted: ❑ Yes El No <br /> w• C <br /> If yes,spoils storage Location: slonad - -= <br /> asc3en — <br /> Covered: ❑ Yes ❑No <br /> = g-vw Pads <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: AG <br /> Depth to Water: q ft' <br /> Grout Material: C,QJI%-&/ : 'Vfi\IO <br /> Gallons of Grout Used: 4::) qO,\ MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation XBoring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ?6Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> Ilons Bas gallons Ba s <br /> Thickest Thinnest 41 Bags Thickest jThinnest 7Bags Bentonite/Gement Mix 3% MIX 5% MIX <br /> 2.5 5 1 1 s 1 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.821 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 25 5 25 50 5 <br /> is <br /> 15 30 6 30 60 6 lil <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 Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sicehd.com <br />