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SAN. JOA Q U I N Environmental Health Department <br /> COUNTY <br /> __ ��reatress grov.s �:err. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 12-4o--A Inspector: A14'ww%,&0 CONSTRUCTION <br /> Facility Address: )Z I(om Ckrn n,-e _bit <br /> Well Address: Total Depth: <br /> WP# ao yo X73 Well#: Drilling Rig Type: 4pT '..1 <br /> Soil Boring#: 6rd9-,06 r <br /> Company: ,,zp,Y Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Drilling p y:� � Screen Length From: To: <br /> Driller Onsite: L,,,3 <br /> Filter Pack From: To: <br /> Consultant: <br /> Geologist: �✓�'*� S/O� X513- Z/B6' Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CO&P�rtON cCCMPLETIONi <br /> Method: G=ndsurt"' T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes []No �ft' <br /> n. <br /> -ft. Ilk <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No x` = A <br /> If yes,spoils storage Location: 810n2d <br /> sacdon <br /> Covered: ❑ Yes ❑No _ <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: Y7 , 3G S <br /> Depth to Water: Tar n• tt' <br /> Grout Material: Wt*t,*-<ewew�- <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: IL i, 11 -9 <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 GPf��1r� Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity CFTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest Bags Bentonite/Cement Mix 3% Mix 5% MIX <br /> 2.5 s 1 s 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 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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />