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%our co <br /> SAN 10AQUIN Environmental Health Department <br /> COUNTY— <br /> Greatness <br /> OUNTY--- <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> ,p3 <br /> Date: O Z: 20 Inspector: SC4_ky`_tF CONSTRUCTION <br /> Facility Ad ress: SC i; tQ. aia,610 7y,*,Vj_.tt _Teri t � <br /> Well Address: To`fal Depth: <br /> WP# 00t1101_7 Well#: Drilling Rig Type: C?7 <br /> Soil Boring#: C.PITy Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: 9j G F.ar+t-- <br /> Driller Onsite: D Screen Length From: To: <br /> Consultant: &Sk Oda:te.5 <br /> Filter Pack From: To: <br /> Geologist: SA164S47`A111- 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: T height <br /> SAMPLING ABOVE-GROUND <br /> CHRMTYHolding Temperature: ��`��1ON c1FnON <br /> Method: G=nd Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No �ft' <br /> K. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: slotted <br /> section <' <br /> Covered: ❑ Yes ❑No gira,s,Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: 214, n• n' <br /> Grout Material: NtA-r Ct imLyuf <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation1ABoring Destruction Bags iz 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 gallons Bags <br /> Thickest Thinnest trBags Thickest Thinnest sBags 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 ('75- 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.socehd.com <br />