Laserfiche WebLink
SAN910AQUIN <br />Environmental Health epartment � <br />—COUNTY— <br />Greatness grows here `�pQP• <br />Monitoring Well/Soil Boring Inspection epor <br />Date: 12Di 2-Z' Inspector: �ll� CONSTRUCTION D3, IDS <br />Facility Addre s: 606 Dn Pet 5 La UJ st t\0� <br />Well Address: Total Depth: ;nS P -Joy- cc��due.- -k-0 <br />WP# Well#: Drilling Rig Type: c0v\�\iCk . <br />Soil Boring#: C'O�k w� Q vry k. SiM <br />Drilling Company: Min 2" Annular EHD Seal Verified: ❑Yes ❑No <br />Driller Onsite:Screen Length From: To: <br />Consultant: I LIQ. 5 . <br />Filter Pack From: To: <br />Geologist: �i� 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 <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth:'/Z <br />Depth to Water: ' aw <br />Grout Material: <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation WBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity K.Tr % ❑Other: <br />Water <br />gal lons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnegs <br />Thickest Thinnest <br />lrBags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 so <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />1 8 <br />40 80 <br />8 <br />casing <br />height —JKf W7F <br />ABOVE -GROUND C 11RlSTY-8Ox <br />COMPLETION COMPLETION <br />Ground surface <br />groLA 1D\ <br />irk <br />n. = ftalo\� k" C�4 <br />.lotted <br />seeton <br />ft. <br />A'j n. dVli\k WVA . <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <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.sucehd.com <br />