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SANJOAQUIN <br /> {� —couNTY Environmental Health Department <br /> Greatness grows here <br /> 9�-fFOP% <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �8 (Z Inspector: V v _ CONSTRUCTION L <br /> Facility Address: 5 lot t�' �� r0 fo N <br /> Well Address: Co r1�r) Total Depth: <br /> WP# DOS '6 41 Drilling Rig Type: <br /> Soil Boring#:_ _ <br /> Drilling Company: Irt>`C Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: <br /> Filter Pack From: To: <br /> Geologist: S <br /> 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 casing <br /> If yes, location and distance: ITt f height <br /> 79— _CWT <br /> SAMPLING ABOVE-caourvo <br /> Holding Temperature: COMPLETION �t.E_ncN <br /> Method: Ground Surface <br /> Screening Method: sn«n <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> SPOILS tt = <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: I slotted <br /> &scion _ 8 <br /> Covered: El Yes El No '�ur `r _ g. i <br /> If yes, material: <br /> �Cske�ck Z <br /> g$ - <br /> tob — <br /> GROUTING or DESTRUCTION Total Depth: lu -25'b <br /> Depth to Water: 13q- 20`1 — ft. <br /> Grout Material: a10`2514�jj <br /> Gallons of Grout Used: per .- ; ATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation�oring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> XC�q) Filter Pack Type/Size: <br /> Gravity -V.4remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 204 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 35 70 7 <br /> 20 40 8 40 80 8 <br /> IY��{e <br /> II 10/16/2017 <br /> IN w vul�y�e S <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 I sicehd.com <br />