Laserfiche WebLink
SANtlOAQUIN Environmental Health Department <br /> —COUNTY— .. <br /> sr.,r <br /> Gre°iness groves here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1 Inspector: Y4t CONSTRUCTION <br /> FacilityA dress: k f fZ <br /> Well Add a s: Total Depth: <br /> WP# ell#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑Yes ❑No <br /> Drilling Company: Screen Length From: To <br /> Driller Onsite: `4 Filter Pack From: To: <br /> Consultant: T�.A Bentonite From: To: <br /> Geologist: MU-4A Grout From: To: <br /> Public Water System Onsite: ❑Yes J1Vo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes 2110 casing <br /> If yes,location and distance: Il IFFYbYb//77I/¢/¢���-- <br /> height <br /> SAMPLING Aeovsa aa.INo C -MM-BOX <br /> CONFLETION COMPLETION <br /> Holding Temperature: orovod s a1wo •—r—�— <br /> Method: or«a <br /> Screening Method: <br /> n. <br /> Verified Chain of Custody: ❑ Yes ❑No I n• <br /> SPOILS yy�' '-" <br /> Contamination Noted: ❑ Yes Ao <br /> If yes,spoils storage Location: al° Sz B <br /> aacdon L{ = <br /> Covered: ❑Yes ❑No __ '. a■ P-K <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:_ <br /> Depth to Water: AV 'W <br /> Grout Material: s MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 17 L2 Casing Type: <br /> []Well Installation 4;&ell Destruction <br /> Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction 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 $Tremie ❑Other: <br /> Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Ba 5 allonz Ba s <br /> Thickest Thinnest #Bags Thickest Thinnest NBagz Benf.OnitelCement MtX 3% MIX rJ%MIX <br /> 2.5 5 1 s i <br /> Bentonite per 41 Ib 1.41 2.47 <br /> 10 <br /> 5 10 2 10 20 2 113entonite per 9411) 1 2.82 4.7 <br /> 7.5 15 3 is 30 3 <br /> t0 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 30 6 30 60 6 <br /> 15 <br /> is 35 7 35 70 7 <br /> 20 4a B 40 eo B 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www sicehd.com <br />