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° cc�, SANaJOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 22- 101 Inspector- 'SUVLk z.l"� CONSTRUCTION 0�'�1 G wdt <br /> Facility Address: 92 1 GJ 2-UZ*J-"010-Y' <br /> Well Address: Total Depth: <br /> WP# 0030'(92- 1 Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: f1-lwy <br /> Driller Onsite: i ►yL Screen Length From: To: <br /> Consultant: C( Lfie,-\- Filter Pack From: To: <br /> Geologist: 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: IF7LT height <br /> 9 W— —IW7:F <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLET(ON COWIEncN <br /> Method: Ground Sumacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> ft. <br /> SPOILS <br /> K� <br /> Contamination Noted: ❑ Yes ❑No =` <br /> If yes, spoils storage Location: slatted <br /> sac9an r _ <br /> Covered: ❑ Yes E]No = i-w+pack <br /> If yes, material: <br /> I <br /> ROU�oW <br /> r DESTRUCTION Total Depth:_ <br /> ep tter: n' <br /> Grout Material: att mgIAT <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 /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity -Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest Jt 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 /> 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 20 40 4 <br /> 12.5 25 25 50 5 <br /> 15 30 30 60 6 <br /> 17.5 35 j7H 35 70 7 <br /> 20 40 40 80 8 <br /> 15"3S (�L�(66) VJ/ I l) 9 WOW V4 L�- �" �"� 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton California 95205 T 209 468-3420 F 209 464-0138 www.s•cehd.com <br /> I I I I I <br />