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:;JOAQUIN <br /> SAN <br /> } — Environmental Health Department <br /> —COUNTY <br /> Gr-eutness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:l _ Inspector: //� 5H CONSTRUCTION <br /> Facility Address: t-L Lk�, 1]tA5M�fC�- <br /> Well Address: Total Depth: 4-0 <br /> WP# Well#:MJV 2 27+ Drilling Rig Type: <br /> 1 . <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: Yes ❑No � •� <br /> Drilling Company: <br /> Driller Onsite:_EU_-&A1 Screen Length From:_ To:�_ Z <br /> Consultant: LZG .� bk) Filter Pack From: To: O <br /> Geologist:_-1(�LJD X0 Grout <br /> From: To: <br /> Grout From:_ To:�_ <br /> Public Water System Onsite: ❑ Yes )` No COMPLETION ❑ Stove Pi ,,_./ <br /> pe 6dChristie Box <br /> Domestic Well Onsite: ❑ Yes ''\\�1No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE—GROUND CHR- <br /> Holding Temperature: COWPLEDON GC*AP�LEn-ON <br /> Method: Gmdnd Surface <br /> Screening Method: a�«� <br /> Verified Chain of Custody: ❑ Yes El No --'=—n- <br /> �� ft. � <br /> SPOILS <br /> YO <br /> Contamination Noted: ❑ Yes ❑No x = r <br /> If yes,spoils storage Location: ' <br /> _ o <br /> slottQd _ <br /> sat�on r = 8 <br /> Covered: ❑ Yes ❑No <br /> grawt pads <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: '— <br /> Depth to Water: n n• <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS DEVELOPMENT <br /> Casing Type: c-, Z <br /> ❑Well Installation ❑Well Destruction Blank O Feet Screen 210 Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: D 07-0 <br /> Bags of Cement: 5 1/,/ OiP4Loq, <br /> METHOD USED Bags Sand/Gravel: 2 <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: 1 3" <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> 67 II/V A <br /> allons Bas Rallons Bags <br /> Thickest Thinnest kBags 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 1 25 5 25 50 5 <br /> 15 1 30 6 30 60 6 <br /> 17.5 1 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.s4cehd.com <br />