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SAN�JOAQU�lit, <br /> `� Environmental Health Department <br /> T <br /> —COUNTY— <br /> Greatness grows here. Irww �sA <br /> t� Monitoring Well/Soil Boring Inspection Report <br /> Date: b460111 Inspe�jto : Vj Ala CONSTRUCTION <br /> .�CO) I Facility Address: aC I Ct__ I Z's <br /> Well Address: S D Total Depth: <br /> WP# 0 VQ 3 Well#• Drilling Rig Type: <br /> Soil Boring#: _120 Min 2"Annular EHD Seal Verified: ❑Yes El No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: a 2 Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ANo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes KINo caoinq <br /> If yes,location and distance: height <br /> SAMPLING ABOVE-GRMNo CHRmyeoX /tn Sf L <br /> Holding Temperature: cowpLETion coMPLEn.oN V IP <br /> Method: T� <br /> onathd Sula4:e grout <br /> II oum <br /> Screening Method: <br /> Verified Chain of Custody: ❑ Yes ❑No 8' Q"C( Silo <br /> n. 1 <br /> SPOILS # (L I <br /> Contamination Noted: ❑ Yes ❑No ——————-- <br /> If yes,spoils storage Location: <br /> s4c7on t � JG <br /> Covered: ❑Yes ❑No — �a ,I".k <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: f = ^^ r <br /> Depth to Water: K tt' <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: AV ea1 <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation 4oring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> ���/// Filter Pack Type/Size: <br /> ❑ Gravity t�QTremie ❑Other: Type of Method: <br /> Water /cement 471b Water Cement 941b <br /> stations Bags srallons Bags _ <br /> Thlckest Thinnest pBags Thickest Thinnest 9Bass Bentonite/Cement Mix 3% MIX 5%Mix <br /> 2.5 5 1 5 10 1 lBentonits p er 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite er 941b 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 /> is 30 6 30 60 6 <br /> 17.5 35 7 35 M 7 <br /> 20 40 9 40 BO B <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.socehd.com <br />