Laserfiche WebLink
S A N AAQ U I N Environmental Health Department <br /> COUNTY- <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: l - 2 Inspector: CONSTRUCTION <br /> Facility Address: <br /> Well Address: Li\, wl• 5 r -L uq,-ir 17'y Total Depth: <br /> WP# ?)_ �� Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: �;J�t�1, Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: Try Filter Pack From: To: <br /> Geologist: tea w-r..G Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 2-No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes J:INo casing <br /> If yes, location and distance: height <br /> —Qw, <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWFLETION COMPLETION <br /> Method: Ground Surlacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -�—n' <br /> ft. <br /> n. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ZfNo <br /> If yes,spoils storage Location: .lotted <br /> sac5on _ <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 'I r __ <br /> Depth to Water: t'`; tt M. <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ti i y= <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation L'J tSOCIn g Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity rBTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> Pail Bags eallons Bags <br /> Thickest Thinnest kBa s Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 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 Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 www.sicehd.com <br />