Laserfiche WebLink
Monitoring Well/Soi <br />Date: 2 2 Z Inspector: o's <br />Facility Address: 12_,�Z �11 V ►'• <br />Well Address:1 <br />WP# -"')'i I L °(� -Well#: <br />Soil Boring#: <br />Drilling Company: n C, -2'Yk <br />Driller Onsite: <br />Consultant: C�� <br />Geologist: Im 7i <br />Public Water System Onsite: ❑ Yes El No <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: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />If yes, material: <br />1 <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material:o Gallons of Grout Used:i, 16, <br />, -t L <br />❑Well Installation ❑Weil D, stiuct oh - I aA <br />❑Boring InstallationNoring Destruction <br />METHOD USED AU�h <br />❑Pressure Grout ACIver Drill <br />❑ Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />SAN 10AQUIN <br />Cement 471b <br />Bas <br />COUNTY <br />Greatness grows here <br />Monitoring Well/Soi <br />Date: 2 2 Z Inspector: o's <br />Facility Address: 12_,�Z �11 V ►'• <br />Well Address:1 <br />WP# -"')'i I L °(� -Well#: <br />Soil Boring#: <br />Drilling Company: n C, -2'Yk <br />Driller Onsite: <br />Consultant: C�� <br />Geologist: Im 7i <br />Public Water System Onsite: ❑ Yes El No <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: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />If yes, material: <br />1 <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material:o Gallons of Grout Used:i, 16, <br />, -t L <br />❑Well Installation ❑Weil D, stiuct oh - I aA <br />❑Boring InstallationNoring Destruction <br />METHOD USED AU�h <br />❑Pressure Grout ACIver Drill <br />❑ Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />water <br />gall ons <br />Cement 94112 <br />Bags <br />Thickest Thinnest <br />ttBags <br />Thickest Thinnest <br />JtBs'js <br />2.5 <br />5 <br />1 <br />5 <br />16 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 +' <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 v <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 t• <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 l <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />Environmental Health Department <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: <br />❑ Yes ❑No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />COMPLETION ❑ Stove Pipe ❑Christie Box <br />n. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />n. <br />Screen Feet <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.secehd.com <br />