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,o CIO <br /> SANUIN Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 2 21 Inspector: '5a�('nc'Ls, CONSTRUCTION <br /> Facility Address: 'Ak-tt CXC1u n KA'-, %Ckd0v) <br /> Well Address: Total Depth: <br /> WP# UO�Alk —Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Cn` 0 Ui Y�is �-�EF7 <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: CkVs rKiia GPA C' ULA Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe []Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: T height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION CCMPLEnON <br /> Method: Ground Surface <br /> Screening Method: 01ar«n <br /> Verified Chain of Custody: ❑ Yes []No ft. <br /> SPOILS <br /> n. <br /> SPOILS = n. <br /> >v = - <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes,spoils storage Location: etoxad <br /> scion <br /> Covered: El Yes ❑Nor _ cnve+Pack <br /> If yes, material: r _— <br /> GROUTING or DESTRUCTION T„o al Depth: L r . <br /> _ <br /> Depth to Water: 1 �4 n- IF n' <br /> Grout Material: 2. i- effvtWr,+ MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 2S016l 1U►�5 <br /> I'.0u+v Casing Type: <br /> ❑Well Installation ❑Well Destruction 4pm Blank Feet Screen Feet <br /> ❑ Slot Size:Boring Installation NBoring Destruction `-n-��_ <br /> �etCyG Bags of Cement: <br /> METHOD USED SYy�S- Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity KTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest uBags Thickest Thinnest ABags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Benton@e 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 1 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 1 www.sacehd.com <br />