Laserfiche WebLink
,M <br /> SANsJ0AQUIN <br /> —COUNTY— <br /> Environmental Health Department <br /> 3y � <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: CONSTRUCTION <br /> FacllityAddres ; 1 <br /> Well Address: Total Depth: <br /> WP# O( yS 0 Well#: Drilling Rig Type: <br /> Soil Boring#: t4, Min V Annular EHD Seal Verified: ❑Yes ❑No <br /> Drilling Company: CMRA t9 Driller Onsite: AmrA&r Screen Length From: To: <br /> Consultant: E k.X Filter Pack Frorn: To: <br /> Geologist: Sam 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 /> SAMPLINGpy �p, o <br /> Holding Temperature: coMa�nort coMat rioN <br /> Method: nminds <br /> Screening Method: Grout <br /> Verified Chain of Custody: ❑ Yes ❑Noe. <br /> a. <br /> SPOILS <br /> Contamination Noted: ❑Yes El No <br /> If yes,spoils storage Location: <br /> Covered: ❑Yes ❑NoqmvW pack <br /> If yes,material: <br /> GROUTING.or-DESTRUCTION.Total Depth:--. .._... <br /> Depth to Water: tt n• <br /> Grout Material: jf CartaMATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:^ 1454MA Casing Type: <br /> ❑Well Installation ;KWell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity Pre ❑Other: Type of Method: <br /> /101-11 <br /> Water ment4 Water cementflft <br /> a Ions Be allons Bags <br /> Thickest Thinnest cgs Thickest Thinnest HBags Bentonite/Coment MIX 3%PAIX 8%MIX <br /> zs s 1 1 s 10 1 Bentonite per 47lb 1A1 2.47 <br /> s 1 10 2 10 20 a Bentonite per 94lb 2.B2 4.7 <br /> 715 1 15 3 is 80 3 <br /> 10 1 20 4 20 40 4 <br /> 12,5 25 5 25 50 5 <br /> 15 s0 6 30 80 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 0 40 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952061 T 209 468-34201 F 209 464-0138.1 www.sloehd.com <br />