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SQN ��QQ��N <br />a Environmental Health Department <br />Vii,':;.: —COUNTY- - <br />\`'0o �' Greotness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Inspector: -7'Qr0, <br />Facility Address: Q.901 q-.. 6onZa.h R-ak <br />Well Address: ki <br />WP#ASO 3-'%59 Well#: <br />Soil Boring#: We k( �- <br />Drilling Company:�� G+otS wells fi pw+�s <br />Driller Onsite: i 4_11% erroSS <br />Consultant: <br />Geologist: <br />Public Water System Onsite: ❑ Yes No <br />Domestic Well Onsite: ❑ Yes CtNo <br />If yes, location and distance: <br />CABAPI INC' <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />CPrlll C <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes 11 No <br />GROUTING or DESTRUCTION Total Depth: 944 <br />Depth to Water: 5 �+ <br />Grout Material: , v%W K; �.c <br />Gallons of Grout Used: 19 Jma S ( Sn lbs <br />Q—moo <br />❑Well Installation XWell Destruction <br />❑Boring Installation ❑Boring Destruction <br />UPTNnn I ICFn <br />❑Pressure Grout ❑Over Drill <br />IxGravity ❑Tremie ❑Other: <br />Water <br />gallons <br />From: <br />Cement 471b <br />Bas <br />Water <br />allons <br />From: <br />Cement 94lb <br />Bags <br />Thickest Thinnest <br />ttBags <br />Thickest Thinnest <br />b Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes El No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />COMPLETION ❑ Stove Pipe ❑Christie.Box <br />31 casing <br />T_ height <br />ABOVE -GROUND C 4RLSTY-SOX <br />COMPLETION COMPLETICN <br />Ground Surface <br />grout <br />�- ft. <br />ft. <br />tt. <br />b <br />.lotted <br />recon — 8 <br />_ = gravel Pads <br />tL = ft. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 30 Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <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.s'cehd.com <br />