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) u�N� so so <br /> AN�JOHN <br /> ilo) <br /> SEnvironmental Health Department <br /> COUNTY - - <br /> �, r Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: V zz tol9 Inspector: AAL& 6w` CONSTRUCTION <br /> Facility Address: fa717 Kc,-jlo--J Kel , <br /> Well Address: Total Depth: ZG/ <br /> WP# co 65191 d Well#: As-9 Drilling Rig Type: < M E 75- <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: 4tltoa) -TeActeef <br /> Screen Length From: SSS To: zLo Per coMS���r,wf <br /> Driller Onsite: ,B ,•pati. � t <br /> Consultant:1�eo Syw�« Filter Pack From: z(.l To: x.53 /��c-,,.tw t4q.� <br /> Z 5a <br /> Geologist: Fo ref Bentonite From: To: z ti 9 <br /> Grout From: z` 'k1 To: o <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: ITTLT height <br /> SAMPLING Asove-caouNo <br /> Holding Temperature: COWPLETION CCOOMPLEncN <br /> Method: Ground Surf acs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �tt. <br /> ft. <br /> tt. <br /> SPOILS . <br /> Contamination Noted: ❑ Yes ❑No =" — <br /> If yes, spoils storage Location: slotted ; = B <br /> sac.on x. <br /> Covered: ❑ Yes ❑No = s <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: zivlt <br /> Depth to Water: tt• tt• <br /> Grout Material: MryL+ <br /> MATERIALS/DEVELOPMENT �� <br /> Gallons of Grout Used: <br /> Casing Type: ��ras astea-C 2 <br /> OWell Installation ❑Well Destruction Blank Feet Screen s' Feet <br /> Slot Size: •cl0 <br /> ❑Boring Installation El Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: ZZ bw –s <br /> X.Pressure Grout ❑Over Drill Type/Brand of Bentonite: e"urro Pti/Y M� <br /> Filter Pack Type/Size: -2/2-/jc'3 <br /> ❑ Gravity WTremie ❑Other: Type of Method:�T�w•.'4 <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas izallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest aBags 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 �' imke3 Pae& AwQ 7A 11Od <br /> �•"` <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 e �� <br /> 17.5 35 7 35 70 7 3 5 ~ <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.s'cehd.com <br />