Laserfiche WebLink
C� 6 <br /> SANUJ0AQUIN Environmental Health Department <br /> COUNTY--Greatness grows here- <br /> t� Monitoring Well/Soil Boring Inspection Report <br /> Date: j f�//�9 Inspector: G CONSTRUCTION <br /> Facility Address:tA-�!j Ovwt �2_,"6i, ....1 ►s(�.o1 <br /> Well Address: Total Depth: <br /> WP# CV3`2yd^`/ Well#: Drilling Rig Type: <br /> Soil Boring#: (r&Fj —Og Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: "I0►�441� <br /> iv Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLETION comPLEneN <br /> Method: G=ndSud=* ' <br /> Screening Method: ply, grout <br /> 021 <br /> Verified Chain of Custody: El Yes ❑No �---n' <br /> n. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: sbtt&d <br /> soon _ <br /> Covered: ❑ Yes ❑No V, <br /> If yes, material: R <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: �V n• n' <br /> Grout Material: r,- ,+ e „r <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ERgoring 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 141remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> gall Bags gallons Bags <br /> Thickest Thinnest 4Bags 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 /> s 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 '-47 ,Ie "w Y <br /> 17.5 35 7 35 1 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 />