Laserfiche WebLink
SAN:,JOAQUIPI Environmei„pl Health Department <br /> COUNTY <br /> ..-ec i.ne ss grows hire. <br /> ` '_� ���JJJ,� Monitoring Well/Soil Boring Inspection Report <br /> Date:y�� Inspector: CONSTRUCTION <br /> Facility d*res <br /> Well Address: Total Depth: <br /> WP# 9E 0310 L t;7 Well#: Drilling Rig Type: <br /> Soil Boring#:4 /)063 — / . �,. z ti . Min 2"Annular EHD Seal Verified: ❑Yes 0N <br /> Drilling Company: Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: Filter Pack From: To: <br /> Geologist: • U Rte? _ 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: --E�� height <br /> SAMPLING ABOVE43ROUND CHRMW-80X <br /> Holding Temperature: OOWLETION COMPLETION <br /> Method: ooum s�+><.—�--- <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No n. <br /> _a. <br /> SPOILS — <br /> 0 <br /> Contamination Noted: ElYes LMN <br /> If yes,spoils storage Location: ,b e <br /> Covered: ❑ Yes ❑No = R,,pPack <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: <br /> Grout Material: t°y MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Z <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill� Filter Pack Type/Size: <br /> V6ravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> Ilons Bags Mims Baas _ <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags _Bentonite/Cement Mix 3% Mix5%Mix_ <br /> 2.s s 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3i <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> is 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 1 40 so 1 0 <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 />