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SANsJOAQUIN <br /> z <br /> � Environmental Health Department <br /> _ <br /> COU NTY— <br /> \ � P1 Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Dater Z� Inspector:S (�'YYI/1�(/IVOh SQ CONSTRUCTION <br /> Facility Address: (00INO R. Nuhtcr Aga, -roxw <br /> Well Address: Total Depth: <br /> WP# 1;;0eg5al Well#: MW-q' Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: onfl wens <br /> Screen Length From: To: <br /> Driller Onsite: JAM$ <br /> Consultant: {�'f l&� Filter Pack From: To: <br /> Geologist: 10hi) -C. Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No <br /> casing <br /> If yes, location and distance: WT <br /> height WT <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLETION COMPLETION <br /> Method: Ground Sumac+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No —it <br /> ft. <br /> ft. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No <br /> - C <br /> If yes, spoils storage Location: slotted <br /> sac9on — <br /> Covered: ❑ Yes ❑No <br /> g-vlw Pax* <br /> If yes, material: s< <br /> GROUTING or DESTRUCTION Total Depth: — <br /> Depth to Water: tt n' <br /> Grout Material: IN eaf <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> 1` <br /> ❑Pressure Grout *ver Drill �1� Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> gall Bags Rallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest ttBags 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 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 1 25 5 25 50 5 I + eA9 f <br /> 155 J <br /> 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s*cehd.com <br />