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SAN <br /> f` <br /> OAQUIN Environmental Health Department <br /> _ =_:J <br /> � 1 <br /> COUNTY <br /> ick<rFoaGreatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: OVIZv Inspector: 4)u (&-4� 2h,L CONSTRUCTION <br /> Facility Address: <br /> Well Address: bgio A.) krv^ ,e ,t ;fele Total Depth: <br /> WP# D O L(Gt 7 Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: .S"(P,, />v.nrlli ��drtiT Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: C,�r�.� iZ,ley Screen Length From: To: <br /> Consultant: 9))�;� 61w"" Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <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: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLS ON �t�.E7toN <br /> Method: G=nd Surf=* <br /> Screening Method: grow <br /> Verified Chain of Custody: ❑ Yes El No <br /> tt. <br /> ft. <br /> SPOILS . <br /> _ - <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: sbnad <br /> section a: <br /> Covered: ❑ Yes ❑No = g-„lw Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: =_ <br /> Depth to Water: n• n' <br /> Grout Material: Via•.-4 <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑BSlot Size: <br /> oring Installation CASoring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ®Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest sBags Thickest Thinnest bBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 Bentonite per 47 Ib 1.41 2.47 <br /> s 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 <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 /> 8�ri I l U`S 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 />