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f SAN J O AQ U I N Environmen Health Department <br /> " L :' —COUNTY <br /> °a ¢ Greatness groves here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 7-i-07 inspector: CONSTRUCTION <br /> Facility Address: 2243- C-kVr tri'vUr 1,- <br /> Well Address: Total Depth: <br /> WP# GP -3 y bqk' Well#: Drilling Rig Type: <br /> Soil Boring#-ffy!j S&-,/I <br /> Drilling Company: Cerse�� Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: Ac)/5--60 Filter <br /> Length From: To: <br /> Consultant:(owlet fe'r Filter Pack From: To: <br /> Geologist: -Z!::a c4 <br /> 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-GROUND <br /> Holding Temperature: COWFLETION GOMPLEMN <br /> Method: Ground Surface "+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No ' <br /> n. <br /> n. <br /> SPOILS _ <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes, spoils storage Location: stonne <br /> sac.on — <br /> Covered: ❑ Yes ❑No `jam <br /> .� — gravel pacsc <br /> If yes, material: „ <br /> GROUTING or DESTRUCTION Total Depth: i =_ <br /> Depth to Water: ZZ i tt. n' <br /> Grout Material: N ecf f(Pi►,r..-F <br /> Gallons of Grout Used: /09, q' 9 MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation XBoring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity B�remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas Fallons Bags <br /> Thickest Thinnest ttBags 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 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 209464-0138 1 www.sacehd.com <br />