Laserfiche WebLink
SAN. 10A0UIN <br /> Environmental Health Department <br /> " } <br /> -- COUNTY-- <br /> Greatness <br /> - COUNTY - <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 2 Inspector: CONSTRUCTION <br /> Facility Address: 4- <br /> E. {pyo�C�►e <br /> Well Address: Total Depth: <br /> WP# 00 2U Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company:. ILI,iQQ( A _ Min 2"Annular EHD Seal Verified: 11 Yes El No <br /> Driller Onsite: i Screen Length From: To: <br /> Consultant: •d\ <br /> Filter Pack From: To: <br /> Geologist: bniriaot. Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ® Yes E]No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes �211\lo casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: coWLETION COMPLETION <br /> Method: Ground Surfaics <br /> Screening Method: E7111 grout <br /> Verified Chain of Custody: ❑ Yes El No �ft. <br /> ft. <br /> tt. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes fgNo = r <br /> If yes,spoils storage Location: slotted <br /> on <br /> Covered: I Yes ❑No <br /> If yes, material: �� 15.1�a( S <br /> GROUTING or DESTRUCTION Total Depth: k <br /> Depth to Water:_';'2 ' <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: /V dcb, <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction b �5 Blank Feet Screen Feet <br /> J <br /> ❑ Slot Size: <br /> Boring Installation IPBoring Destruction jl <br /> �,,✓ Bags of Cement: <br /> METHOD USED 2`� v'` '" Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill ) v Type/Brand of Bentonite: <br /> -I- �ppJ� Filter Pack Type/Size: <br /> ❑ Gravity �Aremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 V 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 1 70 7 <br /> 20 40 8 40 1 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />