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SAN JUAUUIN Environmental Health Department <br /> -- COUNTY — <br /> Greatness grows here . <br /> Monitoring Well / Soil Boring Inspection Report <br /> Date : �,�.,,'t' Inspector : 44s�•.o& CONSTRUCTION <br /> Facility Address : 444l' w • <br /> Well Address . Total Depth : � � a <br /> WP # 00 S/3 Z74 Well # : 40, 7 Drilling Rig Type : <br /> Soil Boring# : Min 2 " Annular EHD Seal Verified . EM ❑ No <br /> Drilling Company : Ore eel r <br /> Driller Onsite : Screen Length From : 25 To : <br /> Consultant : ✓u•�-^•lam Filter Pack From : 6 To : <br /> 0 <br /> Geologist : 1"^XBentonite From : !y To . <br /> Grout From : Z To . • ,� f <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 : height <br /> SAMPLING ASOVE-GROUND <br /> Holding Temperature : COMPLETION COMPLETION <br /> Method . Ground Sumacs '�" <br /> Screening Method : arm <br /> Verified Chain of Custody : ❑ Yes El No donft' <br /> ft. <br /> ft. oono <br /> SPOILS 4jmomonoo= <br /> 4._ <br /> 4" � Y- <br /> Contamination Noted : ❑ Yes El No <br /> If yes , spoils storage Location : <br /> sacdon I <br /> Covered : ❑ Yes ❑ No = t <br /> ack <br /> If yes , material : _— <br /> GROUTING or DESTRUCTION Total Depth : ozs �=- _ <br /> a. _ <br /> Depth to Water : i0 ft• i" • <br /> Grout Material : �ldr��►�► .yr � c�irr�,�,� <br /> Gallons of Grout Used : y � �rllfr•.r MATERIALS / DEVELOPMENT <br /> Casing Type : w6 SG4VO <br /> C� Well Installation ❑ Well Destruction Blank Y Feet Screen Z / Feet <br /> Slot Size : ,O ?.® <br /> ElBoring Installation ❑ Boring Destruction Bags of Cement : <br /> METHOD USED Bags Sand /Gravel : S <br /> Type/ Brand of Bentonite : c orfn <br /> ❑ Pressure Grout ❑ Over Drill <br /> Filter Pack Type/Size : .043 SQ <br /> 14 Gravity ❑ Tremie ❑ Other : Type of Method :P owe. <br /> Water Cement 471b Water Cement 941b <br /> Qallons Bas gallons Bags <br /> Thickest Thinnest # Bags Thickest Thinnest # Bags Bentonite/Cement Mix Salo 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 2Bentonite per 94 Ib 2 . 82 4 . 7 <br /> 7. 5 15 3 15 1 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 s 40 80 s <br /> 10/ 16 / 2017 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468 - 3420 1 F 209 464 - 0138 www . s ehd . com <br />