Laserfiche WebLink
SAN 10AQUIN Environmental Health Department <br /> —COUNTY— <br /> Monitoring, ���,.. _ -�•._. „_�... <br /> �Well/Soil Boring Inspection Report <br /> Date: I (�dl �2 Inspector: '` `& CONSTRUCTION <br /> Facility Address: ���2(j S. (�i'a� WG�►� <br /> Well Add res : Sibcft%,,Total Depth: <br /> WP# Well Drilling Rig Type: <br /> Snub". sU <br /> Drilling Company: <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: E•rkwl Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVEGROUND _ <br /> Holding Temperature: COMPLETION C�LETioN <br /> Method: G=ndS"r<x' <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> ft. ft. <br /> SPOILS " <br /> Contamination Noted: ❑ Yes ❑No aF <br /> If yes,spoils storage Location: i! <br /> slotted a: = <br /> saction <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> NE <br /> GROUTING or DESTRUCTION Total Depth:15, <br /> ;M. <br /> Depth to Water: ft• M ` IFft• <br /> Grout Material: e---r <br /> Gallons of Grout Used: re1FL 4 MATERIALS/DEVELOPMENT <br /> J Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity �<remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> allons Bags gallons Bags <br /> Thickest Thinnest Bags Thickest Thinnest 11Bags 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />