Laserfiche WebLink
SA N J OAQ U I N Environmen . Health Department <br /> COUNTY <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:lz Inspector: L1,1 XI, CONSTRUCTION <br /> Facility Address: I!" 12tV A. 2&4C <br /> Well Address: Total Depth: <br /> WP#(20714tl Well#: Drilling Rig Type: <br /> Soil Boring#: (rCy-td 03 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: e <br /> Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: Lrzeos,,,,A. Filter Pack From: To: <br /> Geologist: rA.,eA (�,�4 L Bentonite From: To: <br /> — 0 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 /> iii <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: cowP�rfoN CoWt.>=ri N <br /> Method: G=ndSurface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> ft. <br /> ft. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: slotted = <br /> ssc9on — <br /> Covered: ❑ Yes El No = ,1w> <br /> ack <br /> If yes, material: <br /> �x — <br /> GROUTING or DESTRUCTION Total Depth: SO <br /> Depth to Water:3 n' <br /> Grout Material: <br /> Gallons of Grout sed: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation oring 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 5?(remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags Rallons Bags <br /> Thickest Thinnest xBags Thickest Thinnest #Bags Bentonite/Cement Mix 3% MIX 5% MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 12.5 25 s 25 50 s S �1 ib 1 1 tj �G-U 0 3 <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 />