Laserfiche WebLink
SANad0AQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Z Z -U Inspector: lam. CONSTRUCTION <br /> Facility Address: mm munj <br /> Well Address: Total Depth: <br /> WP# U ^Well#. Drilling Rig Type: <br /> Soil Boring#: W „ <br /> Drilling Company: Min 2 Annular EHD Seal Verified: ❑Yes ❑No <br /> Driller Onslte: ftW\6Aor Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: rAfNA Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑Yes ❑No crazing <br /> If yes,location and distance: height <br /> SAMPLING xsbv � trxlr�p cHRislvox <br /> Holding Temperature: C° x'N coMt'1Ertort <br /> Method: coo 3nasutaea <br /> Screening Method: erjoui <br /> Verified Chain of Custody: ❑Yes D No <br /> tt. <br /> SPOILS �ft. <br /> Contamination Noted: ❑Yes ❑No o <br /> If yes,spoils storage Location: v. 1 <br /> 'totinsi K, <br /> Covered: ❑Yes ❑Noon • <br /> if yes,material: UU <br /> GROUTING.or-DESTRUCTION.Total Depth:- <br /> Depth to Water: f1. -' #• <br /> Grout Material: �eli.�c24-44- <br /> Gallons of Grout Used: <br /> MATERIALS/DEVELOPMENT <br /> ti IDO <br /> Casing Type: <br /> ❑Well Installation Well Destruction Blank Feet Screen Feet <br /> ❑Baring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> AressureGrout El0verDrill Type/Brand ofBentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity Xremie ❑Other: Type of Method: <br /> Water cyee6t471 Water Cement941b <br /> Ions Bags Rations Bain <br /> Thickest Thinnest gs Thickest Thinnest saags Eentonite/Cement Mix �37-Mlx SOA Mix <br /> a5 s 1 s 10 1 18entorille per 47 lb 1,411 2.47 <br /> 5 10 2 10 20 z Dentonite per 94lb 2.82 4.7 <br /> 7.5 15 8 15 <br /> 10 0 4 20 <br /> 1% 25 5 2550 S <br /> is 80 6 8o 60 6 <br /> 17.5 85 7 65 70 7 <br /> 20 40 8 40 <br /> 10/16/2017 <br /> 1868 E.Hazelton Avenue I Stockton, California 96205 1 T 209 468-34201 F 209 464-0138.1 www.sicohd.com <br />