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PQ"cz SAN�JOAQUIN <br /> '``�??, Environmental Health Department <br /> 19 I�"I `I —COUNTY— <br /> �ec'�*'. Greatness 31ows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:,gr C[2o-c Inspector: rid r_,ws CONSTRUCTION <br /> Facility Address: <br /> Well Address: IS4317 u, Lr<. + Lnt Cmx4 fr..%CR 1 3.'L/ Total Depth: <br /> WP# W ecc"IC lel Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: I}cll <br /> Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: 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: COWPLErtON compl.>_nON <br /> Method: Ground Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> n. <br /> n. <br /> SPOILS . <br /> 0 <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: slotted = 3 <br /> s�c9on <br /> Covered: ❑ Yes ONO g, <br /> vw Pack <br /> If yes, material: < <br /> GROUTING or DESTRUCTION Total Depth: 'Nd =_ <br /> Depth to Water: 1371 n• n. <br /> Grout Material: I! <br /> Gallons of Grout Used:$rYllcs MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ®Well Destruction Blank Feet- Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring 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 gTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest »Bags 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 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 s <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.s*cehd.com <br />