Laserfiche WebLink
SANIOAQUIN <br /> 4 :� � Environmental Health Department <br /> COUNTY <br /> Greorness grows here . <br /> Monitoring Well / Soil Boring Inspection Report <br /> Date : � Ile Inspector : � : (� � CONSTRUCTION <br /> Facility Address : \3 C Wig\k " LAD A ', <br /> Well Address : Total Depth . <br /> WP # ( i `I 0SLICC Well # : Drilling Rig Type . <br /> Soil Boring# : (� Min 2 " Annular EHD Seal Verified : ❑ Yes ❑ No <br /> Drilling Company : <br /> Driller Onsite : Screen Length From : To : <br /> / Y l <br /> Consultant : Filter Pack From : To : <br /> '�c�r � 1� L , y1d : ✓�� � hY Y11 Gl.� � � � � �. <br /> Geologist : —�— � "'TTTBentonite From : To : <br /> Grout From : To . <br /> Public Water System Onsite : ❑ Yes ❑ No COMPLETION ❑ Stove Pipe ❑ Christie Box <br /> Domestic Well Onsite : ❑ Yes [] No using <br /> If yes , location and distance : height <br /> SAMPLING AWVSGROUND <br /> Holding Temperature : COMPLETION OMpoN <br /> Method : Giround Sudw* _ <br /> Screening Method . Grout <br /> Verified Chain of Custody : ❑ Yes ❑ No tL <br /> ft. <br /> some swonewas <br /> .. rft. <br /> SPOILS _ <br /> _ <br /> Contamination Noted : ❑ Yes El Assembler <br /> No <br /> 3� <br /> If yes , spoils storage Location : <br /> sarian x: <br /> Covered : ❑ Yes ❑ No Y , = . <br /> sxMV'w pa�* <br /> fVAssessment <br /> If yes , material : <br /> r ?;� 30 <br /> GROUTING or DESTRUCTION Total Depth :_� �p . .=_ <br /> Depth to Water : n- <br /> Grout Material : AjA4yt— 01 MATERIALS / DEVELOPMENT <br /> Gallons of Grout Used . <br /> Casing Type . <br /> ❑ Well Installation ❑ Well Destruction Blank Feet Screen Feet <br /> ❑ Boring Installation gBoring Destruction Slot Size : <br /> Bags of Cement . <br /> METHOD USED Bags Sand /Gravel : <br /> ❑ Pressure Grout ❑ Over Drill Type/ Brand of Bentonite : <br /> Filter Pack Type/Size : <br /> El Gravity Tremie ❑ Other : Type of Method : <br /> Water Cement I Water Cement 941b <br /> gallons Bajz Rall ons Bags <br /> Thickest Thinnest 4Bags 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 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 /> ft� sees <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 Stockton , California 95205 T 209 468- 3420 F 209 464- 0138 www . sicehd . com <br />