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SAN.JOAQUIN ) Environmental Health Department <br /> _COUNTY— <br /> \`c9cKn%`I Greatness grows here. <br /> Z� ► lootzo„ks�Z&l�/I r� i�tjo�ng 1/U��11/Soil Boring Inspection Report <br /> Date: Z�2/Zo 1pspector: V V J CONSTRUCTION <br /> Facility Address: Z 6 ALjy, <br /> Well Address: Total Depth: <br /> WP# oo Well#: Drilling Rig Type: &0 <br /> Soil Boring#: S V F I to S y P 'S D�) <br /> Drilling Company: —Teti I Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Driller Onsite: p a f Screen Length From: To: <br /> Consultant: L-5 i�i <br /> Filter Pack From: To: <br /> Geologist: 1"14 Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe []Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes,location and distance: � height T. <br /> SAMPLING ABOVE-GRCUNC cwwry-Box T <br /> Holding Temperature: ociwPLETwN COMPLETioN <br /> Method: om0m s+fawv <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No tt' <br /> ft. <br /> SPOILS _tt. <br /> Contamination Noted: ❑ Yes ❑No `' <br /> If yes,spoils storage Location: awttaa ;,3 =_ <br /> sectlon � _ <br /> Covered: ❑ Yes ❑No vivo'Pack <br /> If yes, material: _ <br /> _ 1 — <br /> GROUTING or DESTRUCTION Total Depth: _�;' A'a 7J <br /> Depth to Water: <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> z �// / Slot Size: <br /> ❑Boring Installation ing Destruction 0,leye a Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> Xravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest #Bags _ Bentonite/Cement Mix 3%MIX 5%MIX <br /> 2.5 5 1 5 to I Bentonite per 47 lb 1 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94lb 2.821 4.7 <br /> 7.5 15 3 15 30 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> IS 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 ELE <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 />