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SAN J OAQ U I N Environmental Health Department <br /> COUNTY -- <br /> Greatness grows here. <br /> �7 MonitoringWell/Soil Boring Inspection Report <br /> Date: vL S Inspector: d. tT. CONSTRUCTION <br /> Facility Address: '�95(� W. S (it2i-ioldL2 �. <br /> Well Address: Total Depth: t� -I <br /> WP#00 D Well#: Drilling Rig Type: CPT <br /> Soil Boring#: 01S// 09Tf/491 —Z Min 2"Annular EHD Seal Verified: El Yes El No <br /> Drilling Company: e i n <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: �� <br /> Filter Pack From: To: <br /> ki <br /> Geologist: v► 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 1:1 No casing <br /> If yes, location and distance: Iffa height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLEr(ON COMPLEnoN <br /> Method: Ground Suriaes <br /> Screening Method: ori <br /> Verified Chain of Custody: ❑ Yes ❑No -y--n' <br /> tt. <br /> it. <br /> SPOILS <br /> Contamination Noted: ❑ Yes EJ No r� <br /> If yes, spoils storage Location: 01S/109-1 : 5'V /corned <br /> x — <br /> s.cton <br /> Covered: ElYes ❑No 01-S/109-Z: 36' <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 90 -F4 #• __ <br /> Depth to Water: �( '� . tL -ft. <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Lj o S- <br /> �� Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation 1K 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 23gTremie ❑Other: Type of Method: <br /> Water Cement I Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest #Bags 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 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> n„ 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.s*cehd.com <br />