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qU-A,' <br /> °mac°Gs� SANJOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> Greatness gro.vs here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: $/V?oiy Inspector: 4-r l IFnas} CONSTRUCTION <br /> Facility Address: 151 S 11'^ !ULL. Cc, 1537& <br /> Well Address: Total Depth: <br /> WP# t.v F CC. `t 1 G3Z Well#: 1I-2t c -I Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: m,eldle n Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> g p Y Geri � � r L Screen Length From: To: <br /> Driller Onsite:� �inCar� <br /> Consultant: Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: GOWLErION COMPtE ON <br /> Method: G=nd Ste°`~ <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> n. <br /> ft. <br /> SPOILS . <br /> = o <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: sbtwd <br /> � = B <br /> sac5on <br /> Covered: El Yes 11No = P_* <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: =_ <br /> Depth to Water: 6W4 261' ,p ar.3o n• n' <br /> Grout Material: Aeuf- Ce e. t <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: x l' , �c:»cv 1, <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet- Screen Feet <br /> Slot Size: <br /> ❑Boring Installation 913oring 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 XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> Ilons Bas eallon5 Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.821 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 www.s'cehd.com <br />