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l <br /> /JPf�Vlly C.' <br /> SANJOAQULr Environmbntal Health Department <br /> IQ a C o u N TY— <br /> R / <br /> `N"' Greatness grows here. <br /> o <br /> dd Monitoring Well/Soil Boring Inspection Report <br /> Date: T l 20 OInspector: V'P CZ CONSTRUCTION <br /> Facility Address: jt 12 <br /> Well Address: — Total Depth: <br /> WP# f`l p -io � Well#: Drilling Rig Type: <br /> Soil Boring#: -S�G Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: S Screen Length From: To: <br /> Driller Onsite: 6b Filter Pack From: To: <br /> Consultant: tv (ti <br /> Geologist: h Bentonite From: To: <br /> Grout From: Ila To:—S X'f1u <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes,location and distance: Iffl I height <br /> SAMPLING ABo`E•oAouisict cwalM43Ox <br /> Holding Temperature: cowLET1ON —rCO—MPLEMN- <br /> Method: --G=nd s a T <br /> Screening Method: Grout SI tr�aGC <br /> Verified Chain of Custody: ElYes ❑No -�--n. C- rDL& <br /> —ft. — <br /> SPOILS <br /> o <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: aeon d �. = = I ZN <br /> sac7on 4i � $ <br /> Covered: ❑ Yes ❑No = aavofPack IW <br /> If yes,material: �� l�6/wpflQti <br /> GROU ING o DESTRUCTION Total Depth:--44q±-+b S'Kr'(AC.C. c ' tt l�iI <br /> tt. <br /> Dep o ater: Z stun <br /> Grout Material: Neolf oIMlL MATERIALS/DEVELOPMENT l32' <br /> Gallons of Grout Used: n 'I <br /> Casing Type: <br /> Well installation ❑Well Destruction Blank Feet Screen Feet \(,LA t <br /> Slot Size:{ <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: Cr <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity ATremie ❑Other: Type of Method: <br /> Water cement 471b Water Cement 94lb <br /> E7.5 <br /> ns Ba s allons Bags <br /> Thinnest MBags Thickest Thinnest pBags Bentonitelcement Mix 3% Mix 5% MiX <br /> 5 1 5 10 1 Bentonite er 47 lb <br /> 1.41 2.47 <br /> 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 15 3 15 30 3 <br /> 4 20 40 4 <br /> 25 5 25 50 5 <br /> 30 6 30 60 6 35 7 35 70 7 40 a 40 so a <br /> C 0 b ,_ p W � 7�J W'PV v 10/16/2017 <br /> 1868 E. Hazzelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.swcehd.com <br />