Laserfiche WebLink
SA N:J OAQ U I N Environmental Health Department <br /> —COU NTY—r'. <br /> ��" utne>,s grows (;ere. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 12- Z � Inspector: l CONSTRUCTION <br /> Facility Address: T7,7) <br /> C <br /> Well Addre s: ll Total Depth: <br /> WP# i Well#: Drilling Rig Type: <br /> Soil Boring#: V ''__1) Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Makam <br /> Driller Onsite: 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 El Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING AWVE-GROUND <br /> Holding Temperature: CO&PL1ON COMP�LE730N <br /> Method: G=na Su-tsca <br /> Screening Method: e�«� <br /> Verified Chain of Custody: ❑ Yes ❑No ft- <br /> ft. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: <br /> asc5cn �a = <br /> Covered: ElYes ❑No . <br /> .0 _ �+>acx <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _- <br /> Depth to Water: ft -tt. IFn' <br /> Grout Material: CMMt MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> �;t Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas gallons ea s <br /> Thickest Thinnest #Bags Thickest Thinnest 4Bags Bentonite/Cement MIX 3% MIX 5% MIX <br /> as s 1 1 s 1 10 1 Benionite per 47 Ib 1.41 2.4'7 <br /> 5 62 10 20 2 Bentonite per 94 Ib 2.821 4.7 <br /> 7.5 1 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 1s 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 1 40 1 8 1 40 80 1 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 />