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SAN J UAQ U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows here . <br /> Monitoring Well / Soil Boring Inspection Report <br /> Date : b - ' '�- az Inspector : nAs "ftow CONSTRUCTION <br /> Facility Address : 2 24s Oowwgofo - ,N�— I <br /> Well Address : Total Depth : L5 <br /> Well # : Mw - Drilling Rig Type : <br /> Soil Boring# : Min 2 " Annular EHD Seal Verified : ❑ Yes El No <br /> Drilling Company : j��KtceRC <br /> Driller Onsite : Screen Length From : Z S To : S <br /> Consultant : 6y �4cwo Filter Pack From : LS ' To : y � <br /> Geologist : _A4&w )e Bentonite From : To : .1 <br /> Grout From : Z ' To : d � <br /> Public Water System Onsite : ❑ Yes F1 No COMPLETION ❑ Stove Pipe gChristie Box <br /> Domestic Well Onsite : ❑ Yes ❑ No casing <br /> If yes , location and distance : T height <br /> SAMPLING ABOVE-GROUND CHRLSTY_ <br /> Holding Temperature : GOWLE ION COMPLETION <br /> Method : G'n4 Sumacs '--' <br /> Screening Method . grout <br /> Verified Chain of Custody : ❑ Yes El No ft• <br /> ft. <br /> ft. 40N k <br /> SPOILS <br /> Contamination Noted : ❑ Yes ❑ No _ <br /> _ - o <br /> If yes , spoils storage Location : stogy <br /> Covered : ❑ Yes ❑ No � � <br /> = saw+ pack <br /> If yes , material . <br /> GROUTING or DESTRUCTION Total Depth : 2 S . —• <br /> mommomms <br /> Depth to Water : <br /> Grout Material : Nw*a4l eevwwe <br /> Gallons of Grout Used : Z o6'0gItd'^o4 MATERIALS / DEVELOPMENT <br /> Casing Type : ve SLA Yo <br /> C!Well Installation ❑ Well Destruction Blank %5 Feet Screen � 0 Feet <br /> Slot Size : Flo <br /> ElBoring Installation ElBoring Destruction Bags of Cement : ' <br /> METHOD USED Bags Sand /Gravel : / Y <br /> Type/ Brand of Bentonite : 3�� <br /> ❑ Pressure Grout ❑ Over Drill <br /> Filter Pack Type/Size : 3 <br /> " Gravity ❑ Tremie ❑ Other : Type of Method : Pour <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gall ons Bags <br /> Thickest Thinnest # Bags Thickest Thinnest # Bags Bentonite/Gement 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 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 I T 209 468 - 3420 I F 209 464 - 0138 1 <br /> www . s_icehd . com <br />