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SANJOAQUIN Environmental Health Departments ' <br /> --COUNTY- <br /> C: <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:10/9 ��$ Inspector: W W�ti CONSTRUCTION <br /> Facility Address: �- V S11) f <br /> Well Arldre­,- Ce-*Nr)ru ✓d Total Depth: Var`�JS <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#:_ D � � �U t l Z <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: CY1 <br /> Driller onsite: R. e�yQ-rte. a'S Screen Length From: To: <br /> Consultant: �e_rre.- cont Filter Pack From: To: <br /> Geologist: r;s 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: WT <br /> height <br /> SAMPLING ABOVE-GROUND CHRZTY_ <br /> Holding Temperature: T� COMPLETION WMPLEnoN <br /> Method: D Ground Surface If <br /> Screening Method: } grow <br /> Verified Chain of Custody: ❑ Yes ❑No Bib <br /> n. <br /> SPOILS Bit <br /> Contamination Noted: ❑ Yes ❑No _ <br /> If yes,spoils storage Location: :B1 15bsy sb�od _ B Q�1 <br /> on <br /> Covered: ElYes ❑No 3►L :y <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: B 5 ZO ks <br /> Depth to Water: N -w �G n tt• <br /> Grout Material: 4^-t C1 <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure C2ro\\t ❑Over Drill Filter Pack Type/Size: <br /> �Graviity� ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thinnest >tBags Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 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 3 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.socehd.com <br />