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`1 COUNTY— <br /> SAWdOAQUIN <br /> �" L <br /> Environmental Health Department <br /> q4 "' Greatness grow, Gere. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: K1vX, Inspector: 1 se_ fE"!ti- CONSTRUCTION <br /> Facility Address. &.50 w IOn' fix i r�C&`� 7b <br /> Well Address: — r Total Depth: <br /> WP# t_f 001ft", —We ll#: CP+ _I Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: fw,1412 (✓w Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: t?644 1durkbch_ Screen Length From: To: <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: CokF�7>oN c�oMPorXi <br /> Method: Gmrjd Surface*'T'_ <br /> Screening Method: <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> ft. <br /> tt. <br /> SPOILS x. <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: Won" = . <br /> **clan <br /> Covered: ❑ Yes ❑Nogra= - vOl <br /> pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: So' - =_ <br /> Depth to Water: 6- 2G; <br /> Grout Material: Ncnf- Cei-e-f- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: fi-aL-y Casing Type: <br /> ❑Well Installation '-'Well Destruction Blank Feet- Screen Feet <br /> Slot Size: <br /> ❑Boring Installation QBoring 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 (3Tremie ❑Other: Type of Method: <br /> Water Cement 471b water Cement 941b <br /> Ilons 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 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.secehd.com <br />