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SA N J OA Q U I N—COUNTY Environmental Health Department <br /> Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector:fl.LOA_0 CONSTRUCTION <br /> Facility Address: 401 y1•Act c�y <br /> Well Address: Total Depth:�— <br /> WP# 2 r <br /> �GO_�jSS Well#: �-G Z Drilling Rig Type: 6 <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: r� Yes El No <br /> Drilling Company: (5er'CC"'+ 'iG <br /> Driller Onsite: 00t^wt Screen Length From: .S.Gq To: GG,y 8 <br /> Consultant: I cL �`i Filter Pack From: To: <br /> Geologist: mcwe(.&A5 Bentonite From: To: S-S <br /> Grout From: To:� <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: height <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: COWPrION COMPLEnoN <br /> � <br /> Method: around Surlacs <br /> Screening Method: grout <br /> Verified Chain of Custody: El El No -�---tt- <br /> ft. <br /> —ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: .tonne <br /> ax on = <br /> Covered: ❑ Yes ❑No <br /> 9­1 Pack <br /> If yes, material: >x _ <br /> GROUTING or DESTRUCTION Total Depth: Cos k _ <br /> Depth to Water: S I —ft. ff — tt <br /> Grout Material: ✓le-d- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: oti� Casing Type: <br /> 'Well Installation ❑Well Destruction Blank GO Feet Screen_B Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: �S�JuGS �q �lo <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons 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 lb 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 SO 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s*cehd.com <br />