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S A N, J OAQ U I N Environmental Health Department <br /> —COUNTY <br /> Greotnes5 grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 31 �-( Z( St-, j>, cK <br /> Inspector: CONSTRUCTION <br /> Facility Address: y9.5 Sr t. tZ^'� �►C ,� �"l(,�Mte�. <br /> Well Addre s: Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#:�r --� "�kVU� � <br /> Drilling Company: `Urex c C1.1S'� 2 �(oMin 2"Annular EHD Seal Verified: El Yes []No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: CT- C61 C Filter Pack From: To: <br /> Geologist: -P-a r''1 e Lf Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes [I No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING <br /> ASOVE.&IOUND cwz-ry-BOX. ' <br /> Holding Temperature: CO&FL TION COtvlP=ON <br /> Method: G=rjd Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No ft- <br /> ft. <br /> SPOILS ' _= <br /> •F <br /> Contamination Noted: ❑ Yes El No = — <br /> If yes,spoils storage Location: _ _ <br /> slatted =- � <br /> Covered: ElYes El No sxng-vw Pack <br /> . <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:30 <br /> Depth to Water: 1 tt '- tr. <br /> Grout Material: �G� ( C.er,e'�L� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: G VOC-teo( To �c.( <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Size: <br /> ❑Borin <br /> oring Installation Bg Destruction Bags Slot Siziz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity D<remie ❑Other: Type of Method: <br /> Water cement 471b Water Cement 94 lb <br /> gallons Bas Rallons Bags <br /> Thickest Thinnest Bags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% MIX <br /> — -- —— <br /> s.s s _ 1 s 10 1 Bentonite per 47 Ib 1.4'1 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.821 <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 1 40 80 1 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.secehd.com <br />