Laserfiche WebLink
"o0 co <br /> SQNJOQQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 5 2vZ( Inspector: CONSTRUCTION <br /> Facility Address: 221 S <br /> Well Add_r'e}s: � e 5 Total Depth: <br /> WP# (J"`� Well#: V SOS Drilling Rig Type: <br /> Soil Boring#: S Drilling Compan Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> I� <br /> Driller Onsite: w 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: COMPLETION COUP EnON <br /> Method: G=ne Surface <br /> Screening Method: ofOtA <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> n. <br /> tt. <br /> SPOILS a <br /> a <br /> Contamination Noted: ❑ Yes El No CVe4,-j'r-;� <br /> If yes, spoils storage Location: 4e ?jI I dl�� I slonad ! <br /> bit -6 q <br /> aeon <br /> Covered: El Yes ❑No _ 9,VWPack <br /> If yes, material: -50 <br /> Y <br /> GROUTING or DESTRUCTION. Total Depth: SC7-1"� &br <br /> Depth to Water: 14 0 _71 <br /> Grout Material: <br /> �- Q MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation YNell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout �aQver Drill Type/Brand of Bentonite: <br /> / - Filter Pack Type/Size: <br /> ❑ Gravity 1�TrerdeU o LJOther: Type of Method: <br /> Water Ceme 471b Water Cement 94lb <br /> allons Ba s allons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 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 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 9 6 q 0-5 S <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sucehd.com <br />