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SQNIJOQQUiiv Environmental Health Department <br /> —COUNTY <br /> t�e` ol Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 9/14/-5 lq 1 Inspector: V vCONSTRUCTION <br /> Facility Add ss: ; 101 ' 5 r <br /> Well Address: Total Depth: `0 t6 j <br /> WP# Well#: I �� �MW)Drilling Rig Type: ►"l`l �'[ `l 165 , <br /> Soil Boring#: <br /> Drilling Company: 5' Cct Min 2 Annular EHD Seal Verified: El Yes ❑No <br /> Screen Length From: 100 To: Q <br /> Driller Onsite: I --rr':'qs, <br /> Consultant: Filter Pack From:�1.� To: � _5-&,1A t <br /> Geologist: Bentonite From: r� U To: :7. Z 8 - ss- <br /> 4:74-C- <br /> S <br /> (-Z115b 3 S - c q I q Grout From: To: .� ot�b) <br /> Public Water System Onsite: ❑ Yes ❑NoSid <br /> COMPLETION El Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes 1:1 No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION cooMpptEnct4 <br /> Method: Grwnd StOwe <br /> Screening Method: VZ <br /> gr«A 7S <br /> Verified Chain of Custody: ❑ Yes ❑No 6 <br /> tt. <br /> Oft <br /> SPOILS - — <br /> Contamination Noted: ❑ Yes El No =` — <br /> If yes,spoils storage Location: stoned = d <br /> aselon — <br /> Covered: ❑ Yes ❑No <br /> gravel pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total D pth:_/ . <br /> / / <br /> Depth to Water: i r' � tL & <br /> Grout Material: ° as"trt MATERIALS/DEVELOPMENT <br /> n �C <br /> � l/.�" <br /> Gallons of Grout Used: 1V J, Gl� <br /> �� Casing Ty e: <br /> L4 0 <br /> Nell Installation ❑Well Destruction ^� t Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction rS�2 Slot Size: <br /> / Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: J <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> Type of Method: <br /> El Gravity ,C�'�emie ❑Other:Water Cement Cement 471b Water Cement 941b <br /> allons Bas gall ons Bags <br /> Thickest Thi est kBags Thickest Thinnest ttBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.! 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 l0 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 209 468-34201 F 209 464-0138 www.s'cehd.com <br />