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SAN 'JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> a <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:�/_�j�2,4 Inspector: CONSTRUCTION <br /> Facility Address: ZUCIG S4 ✓4ScGo jq 1 <br /> Well Address: Total Depth: 45 <br /> wp# 24M 1,63 Well#: Drilling Rig Type: (7 tt <br /> Soil Boring#: LA/ —D <br /> Drilling Company: eo b cce Min 2"Annular EHD Seal Verified: Yes 1 <br /> Driller Onsite: ONO <br /> p/G t? Screen Length From:�V To:: �Z <br /> Consultant: 9 r Filte <br /> ar Pack From: •l$ To: 2�1 <br /> Geologist: vl u✓ � CC, <br /> entonite From: 27' To:_ MCArout From: 14 TO: O <br /> Public Water System Onsite: ❑ Yes ONO rC4'II ill_cC"nt Sq� ec— %A' P& ", <br /> Y COMPLETION ❑ Stove Pipe �ZiChristie Box <br /> Domestic Well Onsite: ❑ Yes ONO casing <br /> If yes,location and distance: height <br /> MY <br /> SAMPLING ABOVE-GROUND <br /> oo <br /> COIE-GR N CHRMW43OX <br /> Holding Temperature: COMPLETION <br /> Method: Ground su lxa <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ONO tt <br /> SPOILS ft. <br /> Contamination Noted: ❑Yes ❑No ° <br /> If yes,spoils storage Location: <br /> donee _ $ <br /> aac7an <br /> Covered: El Yes ONO .1� _ aavolPack <br /> If material: <br /> GROUTIUTI NG or DESTRUCTION Total Depth: 24 t <br /> Depth to Water: VI / <br /> Grout Material: ✓1 CC4l C&wte11_.L MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ""3�4ttc4-t 5 <br /> Casing Type: PVL <br /> cell Installation ❑Well Destruction Blank 3Z1 Feet Screen (G , Feet <br /> Slot Size: 10 L G <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: G IOkC4 5 <br /> METHOD USED Bags Sand/Gravel: -t 1,7 �✓ NF2F; SaorA <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: l Jute Ce'L[ ='41 CAVP <br /> Filter Pack Type/Size: <br /> S¢ravity ❑Tremie ❑Other: Type of Method: <br /> 11 Water ment47 Water Cement 94lb <br /> allons allons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest dBags Bentonite/Cement Mix 3% MIX 5% Mix <br /> 2.5 5 1 K25 <br /> 10 1 Bentonite per47lb 1.41 2.47 <br /> 5 10 2 20 2 Bentonite per 94lb 2.82 4.7 <br /> 7.5 15 3 30 3 <br /> 30 20 4 40 4 <br /> 12.5 25 5 15 30 6 17.5 35 7 204080 B <br /> Fi VJ�5 1-tseC t 10/16/2017 <br /> 1868 E. Hazelton Avenue lIl Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />