Laserfiche WebLink
' SAN 10AQUIN <br /> ' Environmental Health Department <br /> --- <br /> COUNTY <br /> Greatness grows here . <br /> Monitoring Well / Soil Boring Inspection Report <br /> Dates 2Z Inspector : i CONSTRUCTION <br /> Facility Address : �0 �� � '�=irk, ►t�;> ,1 <br /> Well Address : telt rte. LL Total Depth : <br /> WP # UI; ( {� � ' Well # : V �l� Drilling Rig Type : <br /> Soil Boring# : Min 2 " Annular EHD Seal Verified : ❑ Yes ❑ No <br /> Drilling Company . r, <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 ?Vo COMPLETION ❑ Stove Pipe ❑ Christie Box <br /> Domestic Well Onsite : ❑ Yes 1 0 casing <br /> If yes, location and distance : height <br /> SAMPLING ABOVE-GROUND CHRZTY_ <br /> Holding Temperature : COMPLErlON COMPLEMON <br /> Method : Ground Suriacs <br /> Screening Method . grout <br /> Verified Chain of Custody : ❑ Yes ❑ No moomms ft • <br /> ft. <br /> SPOILS <br /> Contamination Noted : $ Yes ❑ No <br /> If yes , spoils storage Location : slotted ~. <br /> Covered : ❑ Yes ❑ No <br /> graves pack <br /> If yes , material . A -- <br /> - - - <br /> -GROUTING - or- DESTRUCTION -- Total - Depth :---,'y75--L--- - - - - - - --• --- -- - - - -- - - - - - - - - - - -- — ._ . <br /> Depth to Water : el, 12ft• ft• <br /> Grout Material : - � MATERIALS / DEVELOPMENT <br /> Gallons of Grout Used : � ( Z © euc � S Casing Type : <br /> ❑ Well Installation Well Destruction Blank Feet Screen Feet <br /> ❑ Boring Installation ❑ BSlot Size : <br /> oring Destruction Bags Size : <br /> Cement : <br /> METHOD USED Bags Sand /Gravel : <br /> ❑ Pressure Grout ❑ Over Drill Type/ Brand of Bentonite : <br /> Filter Pack Type/Size . <br /> ElGravity Tremie ❑ Other : Type of Method . <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Rallons Bags <br /> Thickest Thinnest # Bags Thickest Thinnest u Bags Bentonite/Cement Mix 3 % Mix 3 °/ <br /> 2. 5 5 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 3 <br /> 10 20 4 20 40 4 <br /> 12. 5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17. 5 35 7 35 70 1 7 <br /> 20 40 8 40 80 1 8 <br /> 10/ 16/ 2017 <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468 - 3420 F 209 464- 0138 www . sicehd . com <br />