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-61v -,, <br /> =�P" °2 SANJOAQUIN Environmental Health Department <br /> � jl - COUNTY-- <br /> �`�� P' Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: b Inspector: X70. \t5 CONSTRUCTION <br /> Facility A dress: ``������,,,,__ <br /> Well Address: �?UO Ic�elYVlV ,(.M`j `t 0f�:%,F otal Depth: <br /> WP# u(3)L11 'Z-U Z- We #: Drilling Rig Type: <br /> Soil Boring#: CST`l Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: ' X_ . <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: <br /> Filter Pack From: To: <br /> Geologist: <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes E]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 /> CHRISMHolding Temperature: �t"F��N cownEnoN <br /> Method: around Sudwe <br /> Screening Method: Dian <br /> Verified Chain of Custody: ❑ Yes ❑No n' <br /> n. <br /> ft. <br /> SPOILS <br /> x^= a <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: <br /> allotted <br /> Covered: ❑ Yes El No = I-v+pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: cl ,-A- / 'ZZ F} , L(2 <br /> Grout Material: nal fit' C+wviytll- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: >06kAktirNs <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation 5413Slot Size: <br /> oring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity 18-Tremie ❑Other: Type of Method: <br /> Water Cement 4Zj_o Water Cement 941b <br /> gall s Bas gallons Bags <br /> Thickest Thinnest a8a s Thickest Thinnest i7 Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.s s 1� s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 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 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.secehd.com <br /> b': <br />