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�rr <br /> SANJ—COU NTY- <br /> OAQUIN <br /> � Environmental Health Department <br /> " `� <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Iq 2�L Inspector: _C.T(1GiMtY)b(V0► L1 CONSTRUCTION <br /> Facility Add ress: a)-u1'Nii4, (' h <br /> Well Address: Total Depth: <br /> WP# 1 OWN4 Well#: MW•58 Drilling Rig Type: <br /> Soil Boring#: 1 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Ptntrol <br /> Driller Onsite: "Vae Screen Length From: To: <br /> Consultant: Mmiec Filter Pack From: To: <br /> Geologist: t4l fA Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes []No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: 111 <br /> height <br /> SAMPLING ABOVE-GIRCUND _ <br /> Holding Temperature: COMPLETION ccoomPLEncN <br /> Method: Ground Svlacy <br /> Screening Method: act <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> tt. <br /> ft. <br /> SPOILS ; <br /> = o <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: .loth <br /> Covered: ❑ Yes ❑No - s <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 210 2, <br /> Depth to Water: <br /> Grout Material: ���(�' CAY)01-j' r cj k pmabl MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: W': <br /> Casing Type: <br /> ❑Well Installation ell Destruction Blank Feet Screen Feet <br /> ❑Boring Installation []Boring Destruction Slot Size: <br /> 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 XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> Fall Bags gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest uBags 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 l0 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 nn�r 4 <br /> lJ� <br /> 12.5 25 5 25 50 5 11�rLl mq M()-5p t}r Z�a <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 VWIIV� <br /> 20 40 8 40 80 8 V,� ' �I ;J IV�J [�P C" (/ NI , <br /> � <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s4cehd.com <br />