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rOPOUIN�;,, <br /> SAN .,JOAQUIN Environmental Health Department <br /> " `� —COUNTY— - <br /> o�cUJI, Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 61912,02-0 Inspector: tsakh CONSTRUCTION <br /> Facility Address: 2q21 w Uvytlk <br /> Well Address: Total Depth:—2-01 <br /> WP# o6,410-2-/ Well#: Drilling Rig Type: 8 11 H5+ <br /> Soil Boring#: 61 Min 2"Annular EHD Seal Verified: ❑ Yes 11 No <br /> Drilling Company: RAO, Eycy1 Cwh' r Screen Length From: To: <br /> Driller Onsite: c & <br /> Consultant: es Ck- ciao Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CO�"¢'�1ON ccaaPLEnoN <br /> Method: Ground Sudace <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> n. <br /> tt. <br /> SPOILS All14, <br /> Contamination Noted: ❑ Yes ❑No <br /> — c <br /> If yes,spoils storage Location: slotted <br /> sac�oin <br /> Covered: ❑ Yes El No = gravv+pack <br /> If yes, material: <br /> r` <br /> GROUTING or DESTRUCTION Total Depth: > ft. IF _ IF_ <br /> Depth to Water: /is., ft. <br /> Grout Material: N C <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 Installation XBoring Destruction 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 VTremie ❑Other: Type of Method: <br /> Water Ce ent 471b water Cement 94 lb <br /> gallons Bas allons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest #Bags 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 1 25 5 25 50 5 <br /> 15 1 30 30 60 6 <br /> 17.5 35 35 70 7 <br /> 20 40 B 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 />