Laserfiche WebLink
4 <br />SAN 10AQUIN <br />— COUNTY -- <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: � Inspector: Czry w�' CONSTRUCTION <br />Facility Address: t),So I,,.k66& (.,,.,.A <br />Well Address: to Total Depth: <br />WP# A "'1 -6 \ Well#: <br />Soil Boring#: 2 <br />Drilling Company: <br />Driller Onsite: _ -�► { <br />Consultant: W�G�►^ a� f7c .!/'"` `" / <br />Geologist: <br />Public Water System Onsite: ❑ Yes P11110, <br />Domestic <br />- <br />Domestic Well Onsite: ❑ Yes 0 <br />111 <br />0 <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 />rnnn c <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: o <br />Grout Material: N.u' <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation,)�Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />/ Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bags <br />Water <br />eallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest <br />#B <br />Thickest Thinnest <br />It Bags <br />2.5 1 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />qV <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 <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 <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 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes El No <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />COMPLETION ❑ Stove Pipe ❑Christie Box <br />—ft. <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 />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.s'cehd.com <br />