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SANJOA <br /> 10, <br /> ( Q Environmental Health Department <br /> �"'t��kl � —COUNTY— <br /> Greatness grows here. <br /> 9gvon% <br /> Monitoring Well/Soil Boring Inspection Report <br /> ( - <br /> Date: I 2O Ins ecto : � CONSTRUCTION RSV-- a � (P 1 <br /> Facility Address: ��� r Q ✓✓ <br /> Well Address: Total Depth: <br /> WP# 00 1 Ili: ��ro Drilling Rig Type: F#u�Cl <br /> Soil Boring#: <br /> Drilling Company: r,., > Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Driller Onsite: 0��° Screen Length�From; �•J� To: �,5 <br /> Consultant: Oro ------ - Filter Pack From: To: l� <br /> Geologist: r Bentonite From:V— To: <br /> KG rout From:,_ To:T C�G�1W <br /> Public Water System Onsite: ❑ Yes []No ..4 COMPLETION El Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑Noj�QCV..�ok� casing <br /> If yes,location and distance: �i++l`✓7 height <br /> SAMPLING t ABOVEGROUND <br /> Holding Temperature: t �L`�� COMPLETION COMPLETION <br /> Method: -- Gmn°s"t°" <br /> Screening Method: urlw t <br /> Verified Chain of Custody: ❑ Yes ❑No —T--h <br /> n. <br /> SPOILS <br /> a <br /> Contamination Noted: ❑Yes ❑No <br /> If yes,spoils storage Location: T= <br /> sac ton <br /> Covered: ❑ Yes ❑No = I-VWPack <br /> If yes,material: c <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: rje-t C( tt. <br /> Grout Material: b" ATERIALS DEVELOPMENT <br /> 5V <br /> Gallons of Grout U ed: <br /> A11 `gR 0 U-9 !0 ��)Casing Type: <br /> `Well Installatld ell Destructio Blank Feet Screen Feet <br /> ❑Boring Installation,❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Over Drill Filter Pack Type/Size: <br /> Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags _ <br /> Thickest Thinnest NBags Thickest Thinnest Mils _ BentonitelCement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentorlle per 47 lb 1 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonlle per 94 lb 1 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 /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 40 60 0 <br /> 1 16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F A-038 socehd.com <br />