WP0042804 - Laserfiche WebLink

Home Browse Search

SAN 10AQ U I N Environmental Health Department COUNTY---- Greatness grows here. Monitoring Well/Soil Boring Inspection Report Date: 1 t Inspector: CONSTRUCTION Facility Address: Well Address:_ Total Depth: WP# A Z�D'k Wel #: Drilling Rig Type: Soil Boring#: �L Drilling Company: � Min 2" Annular EHD Seal Verified: ❑ Yes ❑No Driller Onsite: Da Wu i3v7 l V1 Screen Length From: To: Consultant: Filter Pack From: To: Geologist: ►�4.zt Bentonite From: To: Grout From: To: Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes ❑No casing If yes, location and distance: T height SAMPLING ABOVE-GROUND Holding Temperature: CONFLErION C� no tFN Method: Ground Surfws If Screening Method: grmn Verified Chain of Custody: ❑ Yes ❑No tt. ft. SPOILS = w Contamination Noted: ❑ Yes El No = If yes, spoils storage Location: .toted = . sac5on — 8 Covered: ❑ Yes ❑No _ t If yes, material: GROUTING or DESTRUCTION Total Depth: Depth to Water: S\ n• tt' Grout Material: VJtw�- (g- MATERIALS/DEVELOPMENT Gallons of Grout Used: -AL t I Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet El Boring Installation Slot Size: goring Destruction Bags of Cement: METHOD USED Bags Sand/Gravel: Type/Brand of Bentonite: ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: ❑ Gravity 96Tremie ❑Other: Type of Method: Water Cement 471b Water Cement 941b allons Bas eallons Bags Thickest Thinnest RBags Thickest Thinnest '!Bags 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 20 420 40 4 12.5 1 25 5 25 50 5 15 30 6 30 60 6 1 35 7 35 70 7 0 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.socehd.com