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)AftJ UAV U 1 IV Environmental Health ®apartment <br /> —COUNTY— <br /> "- Greatness gro.i,s here. <br /> r <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: X Ito /'I Inspector: Lr � CONSTRUCTION <br /> Facility Address: 1 V-t, 2-4 ) <br /> Well Address: Total Depth:2 _ <br /> WP#8 (j w3&�11 Wel#: (�LT_--7 Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: �c�l(e,✓ T —t Min 2"Annular EHD Seal Verified: lk"Yes ❑No <br /> Driller Onsite: Q ��•,,,. c;,Y ,� . t=�v.�,,�,ol� Screen Length From: To: -L-ce0 <br /> Consultant: Filter Pack From: 2,0 To: "Z y 3 <br /> Geologist: <br /> Bentonite From:Z%f 8:. To: 2S 3 <br /> Grout From: e To: 248.<- <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION [R'!Love Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No C!zsins <br /> If yes, location and distance: ♦ naIglzt <br /> r - <br /> SAMPLING ABCVE-4 n00LJNo w ox - <br /> Holding Temperature: cc.wLEMN �Pn$ON <br /> Method: Gmind Smi'C' <br /> Screening Method: erg <br /> Verified Chain of Custody: ❑ Yes ❑No n- <br /> f <br /> ft. i. <br /> SPOILS <br /> �F <br /> Contamination Noted: ❑ Yes ❑No = o <br /> If yes, spoils storage Location: : r <br /> sa on = <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: "9, <br /> Depth to Water: - F <br /> Grout Material: irc, c MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> // Casing Type: 2 <br /> S�u�nk�s r-!"-ce�` <br /> R611 Installation ❑Well Destruction Blank'?,,!; Feet Screen .S- Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: . 0710 <br /> 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 5eremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> gallons Bas gallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 s 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 L I - <br /> 12.5 25 5 25 50 5 — .(J ' l+, k-k <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 40 80 8 <br /> Q68 <br /> 10/16/2017 <br /> azelto�nn Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.slcehd.com <br /> to 6v-k0�vS <br />