Laserfiche WebLink
S A N d 0 A 0 U I N Environmental Health Department <br /> —COUNTY <br /> Greatness grows her <br /> MonitoringWell/Soil Boring Inspection Report <br /> DaterA�7 � Inspector:'DP.P� / <br /> 0_ r1 • CONSTRUCTION <br /> Facility Address: 1 <br /> Well Address: oZ -I& 04LK Total Depth: <br /> WP# G Well#: °r —0— Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: <br /> Screen Length From: To: <br /> Consultant: c' i r QC. <br /> Filter Pack From: To: <br /> Geologist: 14wi 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: 11"TF <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONPLETION COMPLETION <br /> Method: Ground surf"' <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑No �tt' <br /> ft. <br /> tt. <br /> SPOILS ;. <br /> Contamination Noted: ❑ Yes 4No <br /> If yes, spoils storage Location: �✓ r�G� <br /> abttnd _ � <br /> t*c-,'cn <br /> Covered: C Zf� L Yes ❑No = <br /> If yes, material: �oY����✓�L� <br /> GROUTING or DESTRUCTION Total Depth:_ '1 _— <br /> Depth to Water: pku— ft. <br /> Grout Material: <br /> Gallons of Grout Used: 2 30 MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation dell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction gags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ver Drill Type/Brand of Bentonite: <br /> Q <br /> l Filter Pack Type/Size: <br /> ❑ Gravity remie LJOther: Type of Method: <br /> Water Ceme 471b Water Cement 94lb <br /> allons Ba allons Bags <br /> Thickest Thinnest kBags Thickest Thinnest VBags 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 1 35 70 7 <br /> 20 40 8 1 40 80 8 <br /> 1 W JV4 q 0 S 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.sicehd.com <br />