WP0041384 - Laserfiche WebLink

Home Browse Search

g2� SAN d OAQU I N Environmental Health Department COUNTY --- o�ur Greatness grows here. Monitoring Well/Soil Boring Inspection Report Date: Inspector: CONSTRUCTION Facility Address: Well Address: Total Depth: WP# Well#: Drilling Rig Type: Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No Drilling Company: Driller Onsite: Screen Length From: To: Consultant: Filter Pack From: To: Bentonite From: To: Geologist: Grout From: To: Public Water System Onsite: ❑ Yes No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes ❑No casing If yes, location and distance: W- T height T SAMPLING AVE CHRISTY-BOX Holding Temperature: COMPLETION COMPLETION Method: Ground Sumacs Screening Method: grout Verified Chain of Custody: ❑ Yes El No .�- ft ft.. tt. SPOILS a vw Contamination Noted: ❑ Yes El No r" _ If yes, spoils storage Location: slotted asc�on _ Covered: ❑ Yes ❑No If yes, material: GROUTING or DESTRUCTION Total Depth: Depth to Water: ` Grout Material: Gallons of Grout Used: MATERIALS/DEVELOPMENT Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet Slot Size: ❑Boring Installation,Q Boring Destruction gags of Cement: METHOD USED Bags Sand/Gravel: ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: Filter Pack Type/Size: ❑ Gravity 51Tremle ❑Other: Type of Method: Water Cement 471b Water Cement 94 lb allons Bas Rallons Bags Thickest Thinnest uBags Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix 5% Mix 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 7.5 15 3 15 30 3 10 20 4 20 40 4 12.5 25 5 25 50 5 15 30 6 30 60 6 17.5 35 7 35 70 7 20 40 8 40 80 8 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.secehd.com