Laserfiche WebLink
SQNJ 0 A Q U IN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1 �V( 2.` Inspector: CONSTRUCTION <br /> Facility Address: Z2'l,- %C*�-"�O <br /> Well Address: v Ji-- <br /> Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: , b -r2't Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: N"" "CNA �� !6A <br /> Driller Onsite: "� Screen Length From: To: <br /> �J <br /> Consultant: NN,-GA :F,! <br /> Filter Pack From: To: <br /> Geologist: � Bentonite From: To: <br /> g ����� Grout From: To: <br /> Public Water System Onsite: ❑ Yes AN COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes II1No casing <br /> If yes, location and distance: height <br /> —CWT <br /> SAMPLING l� I •- <br /> �►sov>=-GRourro ct-RssrY-sox <br /> Holding Temperature: cowLEr10N COWLETioN <br /> Method: G=nd sudacs _ <br /> Screening Method: oto <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> SPOILS N I R• _ <br /> Contamination Noted: ❑ Yes ON <br /> If yes,spoils storage Location: stoned <br /> section <br /> Covered: ❑ Yes ❑No <br /> = P'Z packIf yes, material: ?c <br /> GROUTING or DESTRUCTION Total Depth: , 5 A _= <br /> Depth to Water: �'2,� n• ' <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: S d.cs Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> El Boring Installation �Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> El 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 /> gallons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags BentonitelCement Mix 3%Mix 5%Mix <br /> 2.5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 T 10 20 2 Bentonite per 94 Ib 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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sicehd.com <br />