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SAJOAQUIN <br /> I� �J —COUNTY-- Environmental Health Department <br /> °9iFP! Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Z 2020 Inspector: S`Ck-h r E J CONSTRUCTION <br /> Facility Address D14 i'j n4i u . x Ie mcei // r L <br /> Well Address: Total Depth: b <br /> WP# 0(9 Well#: Drilling Rig Type: <br /> Soil Boring#: T 1- — CPT Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: r Filter Pack From: To: <br /> Geologist: �YY1� t�i <br /> 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: IT height <br /> 759 <br /> SAMPLING Agpyg.t,RpUND <br /> Holding Temperature: COMPLETION CCOOMP�LEMN <br /> Method: G=nd Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -i—n' <br /> n. <br /> n. <br /> SPOILS <br /> = e <br /> Contamination Noted: ❑ Yes EJ No <br /> If yes, spoils storage Location: .tome <br /> an r — <br /> Covered: ❑ Yes ❑No : _ t <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: v o l <br /> Depth to Water: L4 W 6-r"eQ.iti I Z-6 n• IF <br /> n' <br /> Grout Material: t (�2nu� i <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 VBoring Destruction <br /> 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 LJ,Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bas gall ons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 - 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 10 10 20 2 <br /> 7..5 15 3 15 30 3 Bentonite per 94 Ib 2.82 4.7 <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 Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.socehd.com <br />