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PLtI.j�N� <br /> 'f �` SAN:IOAQUIN <br /> `' ' Environmental Health Department <br /> t: <br /> i' ���`� —COUNTY <br /> Greatness grows here. <br /> 9L/FOPj <br /> Monitoring Well/Soil Boring Inspection Report 01 <br /> Date: Inspector: �— CONSTRUCTION <br /> Facility A re s: 700 r <br /> Well Address: Total Depth: <br /> WP# ell#: Drilling Rig Type: <br /> Soil Bon ng#. <br /> Drilling Company: 7.t.Gc1�_ Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: - Screen Length From: To: <br /> f" Filter Pack From: To: <br /> Consultant: <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 ❑No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING AZOVE-GRCUNn <br /> Holding Temperature: COWLET'ON cCOM tnoN <br /> Method: G=ndSuiacs "+ <br /> Screening Method: oro <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No - <br /> -a' = c <br /> If yes, spoils storage Location: sbttad <br /> sac�on _ <br /> Covered: ❑ Yes ❑No <br /> Z; pacx <br /> If yes, material: <br /> GROUTING or DESTRUCTION Toil Depth: _ <br /> Depth to Water: ft tt' <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well I tallation ❑Well Destruction Blank Feet Screen Feet <br /> I V}c,�iti..v�� Slot Size: <br /> Baring 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 /> El Gravity �remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allows Bas VaI1111ows Bags <br /> Thickest Thinnest kBags Thickest Thinnest .1 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 /> s 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 5 25 50 5 <br /> 15 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.sacehd.com <br />