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SAN�IOAQUIN <br /> < Environmental Health Department <br /> ria <br /> —COUNTY— <br /> ',C. Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: CLli Inspector:k.SCaetern CONSTRUCTION <br /> Facility Address:f422ce N. Lr"etr Scat rX_ <br /> WellAddress: Total Depth: <br /> WP#-1)(G 4()'bii Well#: Drilling Rig Type: Cc'' <br /> Soil Boring#: �t • F�31 ;, P�"? Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: V 8, yV \iGm me <br /> Screen Length From: To: <br /> Driller Onsite: iY•C1Y1y, <br /> Consultant: Geccotl cunstwitniolc <br /> Filter Pack From: To: <br /> Geologist:�{1-y\e.i Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GRCUNi1 <br /> Holding Temperature: comPLECIOH >ToH <br /> Method: °`round Sufaco <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑Non• <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes []No <br /> A - -• <br /> If yes,spoils storage Location: siott�d <br /> Covered: El Yes ❑No _. <br /> Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: - x • <br /> Grout Material: hli'?Ufi ��PIYYxI ►S' <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 C;'Cring 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 eallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement 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 /> 9*3 c3�1 10/16/2017 <br /> 4 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.smcehd.com <br />