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= c2 SAN-bJOAQUIN <br /> COUNTY Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: L? Inspector: )-,o L'. U CONSTRUCTION <br /> Facility Address: "7 -7 w <br /> Well Address: (, Total Depth: 2 3 <br /> WP# Well#: PW-`j Drilling Rig Type: �o•.�.t <br /> Soil Boring#: <br /> Drilling Company: per[��,.� <br /> Min 2" Annular EHD Seal Verified: EKes ❑No <br /> Driller Onsite: 6",rScreen Length From:ZSZ. -I& To:Z�-L. -1 � <br /> Filter Pack From:Z1416 To: Z�G3 <br /> Consultant: �os-,ti4�tc 4.e—� `J <br /> Geologist: ,.� Bentonite From:'2�-( To: i`td <br /> Grout From: 0 To: Z.y <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION Move Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION d oN <br /> Method: around Surfx. <br /> Screening Method: orou< <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No ` <br /> If yes, spoils storage Location: slotted <br /> = = 8 <br /> soon <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 1 =_ <br /> Depth to Water: 30 tt• .� tt' <br /> Grout Material: Ae. - t•�..-c.�— <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> � Casing Type: (,.1 6, C'} ✓\ <br /> L7 <br /> c� 1 Co1`WeIl Installation ❑Well Destruction Blank Z!;--i .7 Feet Screen w Feet <br /> Slot Size: D . c2Z <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: J7,Z- <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: X)#Ae/T? <br /> ❑Pressure Grout ❑Over Drill <br /> � �� Filter Pack Type/Size: <br /> El Gravity [y remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest 1t Bags Thickest Thinnest uBags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.821 4.7 <br /> 7.5 15 3 15 30 3 , <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5I <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 209 464-0138 1 www.sFcehd.com <br />