Laserfiche WebLink
SAN,IOAQUIN Environmental Health Department <br /> COUNTY <br /> Greotne>ss grows !trre. <br /> nrn 1 <br /> Monitoring Well/Soil Boring Inspection Report <br /> 14 <br /> Date;: 1111 Inspector: ��`"`S CONSTRUCTION <br /> Facility Address: 4-112 FC1 Y`Aid�(� W G�VI <br /> Well Address: —� Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: ?)i_ Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: <br /> Driller Onsite: 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 El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: OOWLET1ON COMyPMFnoN <br /> Method: Cit ndSuriaco '+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �ft' <br /> ft. <br /> ft. <br /> SPOILS F= <br /> — <br /> Contamination Noted: ❑Yes El No <br /> C <br /> If yes,spoils storage Location: sbd <br /> sac5en "— � <br /> Covered: ❑ Yes []No = , <br /> Pack <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: i <br /> Depth to Water: N ' <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation >0�ell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation 0ring Destruct, 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 ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons gallons Bags <br /> Thickest Thinnest 'Bags Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 1,5% Mix <br /> -- — --- <br /> - is – - s ----- -— 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib -i.821 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 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 1 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 />