Laserfiche WebLink
SA N J OAQ U IN Environmental Health Department <br /> COUNTY-- <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:(� Z Inspector: S'({ 0lM m QVImOJO CONSTRUCTION <br /> Facility Address: Df OkhpAA- <br /> Well Address: Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes []No <br /> Drilling Company: UL Tal Cpotw. <br /> DrillerOnsite: -�tgg S(X)GQ-UScreen Length From: To: <br /> Consultant: Ozprl Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-CRCUND _ <br /> Holding Temperature: COWPLEMN C1FTIcN <br /> Method: around Surf=* <br /> Screening Method: firms <br /> Verified Chain of Custody: ❑ Yes ❑No -tt• <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: stood <br /> soon <br /> Covered: ❑ Yes []No = g, 1w <br /> Pack <br /> If yes, material: z< _ <br /> 1 _cc <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: �v`7j tt. 2F = tt. <br /> Grout Material: � � 1 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation /ell Destruction Blank Feet Screen Feet <br /> /� "_ Slot Size: <br /> El Boring Installation ❑Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> El Pressure Grout ver Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity V remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gall Bags Rallons Bags <br /> Thickest Thinnest JJBags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 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 `n n VAN( A 1� AA <br /> 15 30 6 30 60 6 1 <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.secehd.com <br />