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SAN, JOAQUIN Environmental Health Department <br /> --COUNTY— <br /> .` ;.,F= Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: l `/L� Inspector:IJ� lI,a - ( 5U"Atf CONSTRUCTION <br /> Facility Address: �Dl oo 5..�i'f Cb/f IN'v <br /> Well Address: Total Depth: <br /> WP# GD-3S950 Well#: Drilling Rig Type: <br /> Soil Boring#: �Z F'- 00 I <br /> Ck Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Geo— <br /> Driller Onsite: /V-L_`C Screen Length From: To: <br /> Consultant: 4 C 43.M Filter Pack From: To: <br /> Geologist: gyros K--,, Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes 1:1 No casing <br /> If yes, location and distance: height <br /> SAMPLING Agdyg.GRpUNp <br /> Holding Temperature: COMPLETION �oMPPtznoN <br /> Method: around Suri°" <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> it. <br /> —ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: abt:Qd <br /> s�c9on = 3 <br /> Covered: ❑ Yes ❑NoSE _= grsvoil i <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:_' _ <br /> Depth to Water: -_6Dtt. — n- <br /> Grout Material: "-f tr..Eityt-P� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Jr Q e'-I <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation IZBoring Destruction Bags Size: <br /> Cement: <br /> METHOD USED O„Wfel", �,�5;h Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ®Tremie ❑Other: Type of Method: <br /> Water Ceme 471b Water Ceme t 941 - <br /> allons Bas gallons Bags <br /> Thickest Thinnest pBags Thickest Thinnest sBags Bentonite/Cement Mix 3% Mix 3% 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 1 30 6 30 60 6 <br /> 17.5 1 35 7 35 70 7 <br /> 20 40 _C8 40 80 8 <br /> q0 9(�``(I 9 )( i({�� (� 6 �)( Lj 10/16/2017 <br /> 1868 E. azelton n,Avenue r Stbck oalltornia 95205 1 T 209 468-3420 1 F 209464-0138 1 www.s'cehd.com <br />