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SAN,JOWR, <br /> 'y Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: d� s `' Inspector: CONSTRUCTION <br /> Facility Address: J 9 t'( #41(1•' c 44 o <br /> Well Address: Total Depth: 11 -S_ <br /> WP# o0 3q g 73 Well#: "-io Drilling Rig Type: NwJ FJ — <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: K Yes ❑No / <br /> Drilling Company: Cas 19i•Z,6 ' �'/� <br /> Driller Onsite: av��1 <br /> Screen Length From: "b To: '! _ ��,,.+s � <br /> Filter Pack From: 71'S To: '-(s yy"" y0 <br /> Consultant: D-, <br /> Geologist: <br /> Bentonite From: W40' To: 35 <br /> JA- t <br /> Grout From: 3S To: 5 <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No d Flash ,Y.�,•-.f <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GRCUND <br /> Holding Temperature: COWLS MN caAPtFnoN <br /> Method: G=nd Surat* <br /> s <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No o� C' n. <br /> 5 tt. <br /> SPOILS <br /> SH. <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: abttod x- _ <br /> on <br /> Covered: ❑ Yes ❑No = g,W Pack <br /> If yes, material: ` <br /> GROUTING or DESTRUCTION Total Depth: 7(•5 <br /> -v <br /> Depth to Water: No Acdot -, G.AJ Ye--t ( tt• �� tt' <br /> Grout Material: Need ce►,e..47 o ' Z -x h•''t <br /> f <br /> Gallons of Grout Used: 1/0 0 oM•-Y A- ''der MATERIALS/DEVELOPMENT <br /> Casing Type: p-le c e_t,Ka <br /> E Well Installation ❑Well Destruction Blank Sv' Feet Screen z�& Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: o o La <br /> Bags of Cement: 2.0 ! <br /> METHOD USED Bags Sand/Gravel: Z6 1:1;3 (O ! 6 Tla�s•'ror�3a•,O <br /> Type/Brand of Bentonite: 31ff �,M <br /> Coafe4 t <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: ±(3 <br /> ❑ Gravity [�Tremie ❑Other: Type of Method: <br /> Water CemenL9M_ water Cement 94 lb <br /> gall s Bas gallons Bags <br /> Thickest Thinnest »Bags Thickest Thinnest ttBags 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 10 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 [O � k �d <br /> 20 40 8 40 80 8 / <br /> rn•`x 2 ; yv bas 5 H j t b rh.3t :.&.- t ov -t( HL /� x 10/16/2017 <br /> A5 6ukr 6" L <br /> 1868 E. Hazelton AvZn—ue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.s'cehd.com <br />