Laserfiche WebLink
SANt]0A0UIN <br /> COUNTY Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Dater Inspector: A-A EEe� CONSTRUCTION <br /> Facility Address: �l�(S' Sa!'latnAv <br /> Well Address: Total Depth: <br /> WP# V Well#: 2 Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: L Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: /cr Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No —� casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> CONYLETION LY-BOX <br /> COMP <br /> Holding Temperature: con+riEnoN <br /> Method: Ground ulao• •—r <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑Yes ❑No -n• <br /> tt. <br /> SPOILS <br /> a <br /> Contamination Noted: ❑Yes ❑No ° <br /> Al(If yes,spoils storage Location: <br /> #•coon ? _ 8 <br /> Covered: ❑ Yes El No gmvwPack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: ! T <br /> Depth to Water: n• i I TM• <br /> Grout Material: if/ C MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 150 ��t((acL +Lo <br /> Casing Type: <br /> ❑Well Installation *ell Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure GroutAver Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ATremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags stations Ba s <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags BentonitelCement Mix 3%Mix 5%J�477 <br /> 2.5 s 1 s 10 1 Bentonite per 47 Ib 1.41 2 <br /> s io 2 to 20 2 <br /> ZS 15 3 15 30 3 Bentonite per 94 lb 2.82 <br /> � <br /> to 20 4 20 40 4 <br /> 12.5 25 5 25 s0 5 <br /> i5 30 6 30 60 6 <br /> 17.5 35 7 1 95 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.s*cehd.com <br />