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I <br /> SAN- 10AQUIN Environmental Health Department <br /> - COUNTY--- - <br /> -`9;Foa'°`F-'. Greatness grows here. <br /> / Monitoring Well'//Soil Boring Inspection Report <br /> Date: In pectora /i CONSTRUCTION <br /> Facility Address: A r. <br /> Well Address: Total Depth: <br /> WP# 85- Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: r t Screen Length From: To: <br /> Driller Onsite: r <br /> Consultant: [ '140 Filter Pack From: To: <br /> Geologist: /V; Ci SS'o 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: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLETION CCMP�LEncN <br /> Method: Ground Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �ft' <br /> ft. <br /> ft. <br /> SPOILS 41 <br /> 10 <br /> Contamination Noted: ❑ Yes El No ;F <br /> If yes, spoils storage Location: <br /> slotted <br /> a�c9on — B <br /> Covered: ❑ Yes ❑No _ 9-01 Pack <br /> If yes, material: r <br /> GROUTING or DESTRUCTION Total Depth: 5Q t - <br /> Depth to Water: -1)- S 21 tL n. <br /> Grout Material: Alza <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 14 0 qac Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation gBoring Destruction Bags Size: <br /> Cement: <br /> METHOD USED we�'_1�9 i h Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity D?Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest xBags Thickest Thinnest #Bags Bentonite/Gement 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 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 6rj q'A'f s ZD bi J 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sFcehd.com <br />