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r " z SKJOAQUIN <br /> � —COUNTY— Environmental Health Department <br /> Oq "Z� Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: X.1'�jqftj ► , 4 CONSTRUCTION <br /> Facility Address: ye`t <br /> Well Address: t-bCZA-DUB Total Depth: <br /> WP#2.6 9TO Well#: Drilling Rig Type: <br /> Soil Boring#: fm fllq�3, HI-6 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: (z{I2p_A� hwN <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: Kali' leyi p GIa Izr, 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 /> WT <br /> If yes, location and distance: 11—f <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMP=CN <br /> Method: Gcound Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �ft' <br /> ft. <br /> ft. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes,spoils storage Location: stonQd <br /> a�1on <br /> Covered: ❑ Yes ❑No <br /> g-wvl pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 5LJ <br /> Depth to Water: la-b& —ft. n' <br /> Grout Material: Neat cf4j=k MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 0 0a A'm <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation Xporing Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity KTremie ❑Other: Type of Method: <br /> Water Cement 47lb Water Cement 941b <br /> gall] s Bags gallons Bags <br /> Thickest Thinnest #Bags 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 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 01 •I.ns r'Gtf 01^+ <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 1 70 7 <br /> 20 40 8 40 1 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.s'cehd.com <br />