Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
SQN �JUA (� UIN Environmental Health Department <br /> t 1114 COUNTY <br /> `` gc � Fou Greatness growls here . <br /> Monitoring Well / Soil Boring Inspection Report <br /> Date : LI c Inspector : �NV, t •L CONSTRUCTION <br /> Facility Address : -'1 �� t4 � _ � li ��� �' <br /> Well Address : Total Depth : <br /> WP # ID low Well # : Drilling Rig Type : <br /> Soil Boring# : tk i S 31 ' <br /> ; 5 Min 2 " Annular EHD Seal Verified : El Yes El No <br /> Drilling Company : 1r.. St_ ?� � ` � <br /> Driller Onsite : Screen Length From : To . <br /> Consultant : flz� .� 6 ti° tom ,,, ;s �^u� 1% If <br /> liter Pack From : To . <br /> Geologist : 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 using <br /> If yes , location and distance : height <br /> SAMPLING ASOVE-GROUND <br /> COWLS ION CNRi5TY-80X <br /> Holding Temperature : COWNXnON <br /> Method : G=nd Sur1x. ... <br /> Screening Method : flrout <br /> Verified Chain of Custody : ❑ Yes ❑ No <br /> >t. <br /> �n. somoo <br /> SPOILS44 <br /> n <br /> Contamination Noted : ❑ Yes ❑ No <br /> If yes , spoils storage Location . _ <br /> sicttad <br /> ssc;ion <br /> Covered : ❑ Yes ❑ No w = �, pack <br /> Isr <br /> If yes , material . ` 100111101114K <br /> __.. <br /> •, i <br /> GROUTING or DESTRUCTION Total Depth : 30o � K — tt. <br /> Depth to WaterI � PC ale ;; ---�' <br /> Grout Material : ti z �: � I' r .fink <br /> Gallons of Grout Used : MATERIALS/ DEVELOPMENT <br /> Casing Type . <br /> ❑ Well Installation ❑ Well Destruction Blank Feet Screen Feet <br /> Slot Size : <br /> El Boring Installation M,Boring Destruction Bags of Cement : <br /> METHOD USED Bags Sand /Gravel . <br /> Type/ Brand of Bentonite : <br /> ❑ Pressure Grout ❑ Over Drill <br /> Filter Pack Type/Size . <br /> I3 Gravity ❑ Tremie ❑ Other : Type of Method : <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eall ons Bags <br /> Thickest Thinnest # Bags Thickest Thinnest # Bags Bentonite/Gement Mix 3 % Mix 5 % Mix <br /> 2. 5 5 1 5 10 1 Bentonite per 47 Ib 1 .41 2047 <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 /> 1s 30 030 60 6 <br /> 17. 5 35 7 35 70 7 <br /> 20 40 8 40 80 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 />