Laserfiche WebLink
SANJOAQUIN <br /> Environmental Health Department <br /> Ott✓ `' —COUNTY <br /> 44. Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: t-+ – CONSTRUCTION <br /> Facility Address:_E-" A;a� <br /> Well Address: Total Depth: <br /> WP# 00 M't"I I Well#: Drilling Rig Type: <br /> Soil Boring#: zc;, C51 Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: �—Nrn► C,.,^ <br /> Driller Onsite: fZ '0" Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING wsovsGaoUtac <br /> �h�' iON <br /> Holding Temperature: cc%wLEngN <br /> Method: °`n`"'d S">i"' <br /> Screening Method: arout <br /> .� <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> fi. <br /> ft. <br /> SPOILS — <br /> aV C <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: s�ttQd <br /> saccn '— <br /> Covered: ❑ Yes ❑No = �4 <br /> VS4 Pack <br /> If yes, material: <br /> _ <br /> GROUTING or DESTRUCTION Total Depth: 10 (� <br /> Depth to Water: o IF <br /> Grout Material:erect (°t,,,,x-JK— MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: "?> "Lo <br /> Casing Type: <br /> ❑Well Installation ❑]�Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation E? oring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pr ssure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Rallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest Bags Bentonite/Cement Mix 3% Mix 5% Mix_ <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10' 2 10 20 2 Bentonite per 94 Ib 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 w <br /> v" �e'� f v �^ -�-1444 ®'S �? B"1 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.slcehd.com <br />