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SANJUAQUIN Environmental Health Department <br /> —COUNTY— <br /> • ". Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �Z ='yy I spectorp: SOy"' CONSTRUCTION <br /> y I u� 1� ye-�SScKfv`YL <br /> Facility Address: Total Depth: <br /> Well Addr <br /> WP# (f Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: C4'�i e Screen Length From: To: <br /> Driller Onsite: af10 ^� Filter Pack From: To: <br /> Consultant: rL To: <br /> Bentonite From: <br /> Geologist: �i^i1 SQ ww w Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe []Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> height <br /> If yes, location and distance: <br /> SAMPLING /gOWLETIOND ComPLETION <br /> COMPLETION COMPLETION <br /> Holding Temperature: around Surtac. --r--^--' <br /> Method: N grout <br /> Screening Method: —tt <br /> Verified Chain of Custody: ❑ Yes ❑No tt• <br /> SPOILS "'9 = e <br /> ; o <br /> Contamination Noted: ❑Yes ❑No <br /> If yes, spoils storage Location: swnad = S <br /> wc3onj <br /> Covered: ❑ Yes ❑No _ grivs,Pack <br /> If yes, material: t <br /> GROUTING or DESTRUCTION Total Depth: tt - tt. <br /> Depth to Water: IW#' TG ` <br /> Grout Material: ' T MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: fJl� 21S c7s7/°"� Casing Type: <br /> ❑Well Installation ell Destruction <br /> Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> Type of Method: <br /> ElGravity RTremie ❑Other: <br /> Water Cement 471b Water Cement 941b <br /> allons Ba s allons Ba <br /> Thickest Thinnest aBags Thickest Thinnest 9Bags Bentonite/Cement Mix 3%Mix 5% Mix <br /> 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 t to 20 Bentonite per 941b <br /> 5 1 2 <br /> 2.82 4.7 <br /> 5 0 <br /> 7.5 15 3 15 30 3 6n'U4 /M"% <br /> 10 20 4 20 40 4 •j0 ,SQ//e`Q <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 40 0 B 'ram <br /> 20 40 8 yp 1p!/ns 10/16/2017 <br /> f ;ss° 5yyy���1- <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T't09 468-3e20 I F 209 464-0138 1 Wm%cehd.com I <br />