Laserfiche WebLink
- ; � ,3A IV a�UAI�U I IV Environmental Health Department <br /> I" —COUNTY— <br /> Greatness grows dere. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 17, Itgja Inspector: L...' '4- CONSTRUCTION j <br /> Facility Address: inpo E P ,� <br /> Well Address: Total Depth: <br /> WP# V03?L,f Well#: Drilling Rig Type: <br /> Soil Boring#: Z V" 6S- 93 Z,�,,g, �v <br /> Drilling Company: (fe& -fir � K.r-�.,�_ {+' 1a,.Ar+- Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: N k.k Screen Length From: To: <br /> Consultant: AI"C,M 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 ❑No casing <br /> If yes, location and distance: haIgnt <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: cowLE-nxoH <br /> CO&TLETION <br /> Method: Cdr=nd Surf;" <br /> Screening Method: yrt <br /> Verified Chain of Custody: ❑ Yes ❑No f- <br /> it_ <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes []No <br /> If yes, spoils storage Location: ar <br /> ` = a <br /> Covered: ElYes ❑Nocn _ <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: IN' S �I1•� <br /> Depth to Water:_ 1Jt- <br /> Grout Material: Vl4AA- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:- OW 0) ^'q 0� Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> � Slot Size: <br /> ❑Boring Installation EiKoring 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 C'?"Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bas gaill ons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags Bentonite/Cement Mix 30/. Mix 5% Mix <br /> 2s 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10' 2 10 20 2 �J Bentonite per 94 lb 2.82 4.7 <br /> 7,5 15 3 15 j 30 3 <br /> 1 20 4 240 <br /> 40 4 u <br /> 12..5 25 5 50 5 <br /> 15 30 6 60 6 <br /> 17.5 35 7 70 7 <br /> 20 40 8 80 8 .I k6 <br /> 1 <br /> /II 10/16/2017 <br /> ti <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 IF 209 464-0138 1 www.sicehd.com <br /> 0 <br />