Laserfiche WebLink
,.a AO <br /> =�c° SAN_J0A0UIN Environmental Health Department <br /> � �Jf <br /> COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 2 Inspector: �(!vti CONSTRUCTION <br /> Facility Address: <br /> Well Address: Total Depth: <br /> WP# 0(-82-51 2 Well#: Drilling Rig Type: <br /> Soil Boring#: %t L�i 6 , L5 1 _� Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company:' - <br /> k . <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: L 5&u <br /> 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 ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONFLETION CZMPLEnoN <br /> Method: G=nd Surface <br /> Screening Method: OfO1t <br /> Verified Chain of Custody: ❑ Yes El No +---n' <br /> n. <br /> it. <br /> SPOILS ? <br /> Contamination Noted: ❑ Yes ❑No = r <br /> C <br /> If yes,spoils storage Location: abttod <br /> a�c.on _ <br /> Covered: ❑ Yes El No _ gravel Pack <br /> If yes, material: 9 / <br /> l� _ <br /> GROUTING or DESTRUCTION Total Depth: � I � <br /> Depth to Water: IN �' tt' <br /> Grout Material: � b MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction IPA Blank Feet Screen Feet <br /> VK Slot Size: <br /> ❑Boring Installation Boring Destruction' S Bags of Cement: <br /> METHOD USED 1 WrC Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> VjressureGrou er <br /> PDrill ��� �.Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas allons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest JV Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 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 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sacehd.com <br />