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. : , <br /> / °° °°z h SANAAQUIN Environmental Health Department <br /> Pv <br /> COUNTY- <br /> � c9�, P' Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inector: SU CONSTRUCTION <br /> Facility Address: TVA Ma <br /> la \y �Oc -{�d� �� ( hj �, L{y <br /> Well Address: Total Depth: 1 E-x <br /> WP# 060mil —27 Well#: Drilling Rig Type: <br /> Soil Boring#: t -2-0-0 <br /> Drilling Company: Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Screen Length From: To: <br /> Driller Onsite: nL�e <br /> Consultant: 74TNW ('pJ'p3 <br /> Filter Pack From: To: <br /> Geologist: R.CYL <br /> 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: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWF'LETION oN <br /> Method: Ground Surf=* <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -� n <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes, spoils storage Location: <br /> slotted <br /> sacZon <br /> Covered: ❑ Yes ❑No _ g-VW PaCK <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: ti(:�I M <br /> Grout Material: t� (t o cer vt✓_.-s{- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Size: <br /> El Boring Installation (],Boring Destruction Bags Slot Siziz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity VTremie ❑Other: Type of Method: <br /> Water /'CementA17lb Water Cement 941b <br /> allons Bags eallons Bags <br /> Thickest ThinnestBags Thickest Thinnest tlBags 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 <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 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />