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SAN, 0A0UIN <br /> 1 Environmental Health Department <br /> C(!✓1�c` J —COUNTY— <br /> r <br /> Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: rJa5t a� CONSTRUCTION <br /> Facility Address: llaO-$" Mu•% SL-1cf r <br /> Well Address: Total Depth: NS <br /> WP# co L1037ff Well#: MW Drilling Rig Type: 11f~ /Jcenxs Y•� <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: 2'1es ❑No <br /> Drilling Company: C-as uit le .' _ t t <br /> Screen Length From: To: <br /> Driller Onsite:(�r�' Z5 c/S r ,•gtew� <br /> Filter Pack From: ySr To: lop 'Sh^ <br /> Consultant: r yr <br /> Geologist: 6 �"��f t��� 6 8'ad Bentonite From: L3 To: Lo f e d <br /> Grout From: 20r To: 2 ✓��:5 <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe Rdristie Box <br /> wzc bt te ^^74'f <br /> Domestic Well Onsite: ElYes E]No <br /> casing <br /> If yes, location and distance: nasyna <br /> kk T <br /> SAMPLING ABOVE-GROUND CHglM-BOX <br /> Holding Temperature: 0016PLE ION COMPLETION <br /> Method: Ground su4aC—+ <br /> p/SA <br /> Screening Method: $ gf01t <br /> Verified Chain of Custody: ❑ Yes ❑No Z3t 7—n, <br /> SPOILS _ <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: ,wttaa <br /> 4arion � 8 <br /> Covered: ❑ Yes ❑No + _ <br /> 7 91 4 Pack <br /> If yes, material: =_ <br /> GROUTING or DESTRUCTION Total Depth: 146' yja = 4SI n <br /> Depth to Water: n' <br /> Grout Material: N¢2 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Casing Type: PVC- Sc-4 4d L <br /> OWell Installation ❑Well Destruction Blank 25' Feet Screen Zoe Feet <br /> Slot Size: cslO <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: T!7 fAJ <br /> METHOD USED Bags Sand/Gravel: 14- bu .f <br /> Type/Brand of Bentonite: Vj'' Cw&6 <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: #0./Z <br /> K Gravity ❑Tremie ❑Other: Type of Method:.5PPeft, ,'C <br /> Ce Water Cement 941b <br /> olio s a s gallons Bags _ <br /> Thi Thinnest I NBags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 s 1 s 10 1 Bentonite per 47 lb 1 1.411 2.47 <br /> 5 10 2 10 20 2 lBentonlisperg4lb 2.821 4.7 <br /> 75 1 15 1 3 15 <br /> 30 1 20 1 4 20 40 4 <br /> 12.5 1 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 35 70 7 <br /> 20 40 40 BO B <br /> Ira e�� -6� 1", k 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />