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1 pVl.y <br /> SAN%JOAQUIN Environmental Health Department <br /> �"'�•`-_�_ �� —COUNTY—. <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ZP>z Inspector: N145x-,O*' CONSTRUCTION <br /> Facility Address: Sea 1•41.ufi sf-lr.f <br /> Well Address: Total Depth: <br /> WP#60V,<yg1(o 5'X/3 Well#: Ma 7S I*V-� Drilling Rig Type: <br /> Soil Boring#: /tin/^�� Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: 15 w �i Screen Length From: To: <br /> Consultant: yeAW Aw yj Nlu/^73g Filter Pack From: To: <br /> Geologist: Ae f Bentonite From: To: <br /> ry)W,/v Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ONO casing <br /> If yes, location and distance: height <br /> SAMPLING ASOVF.GROUND T <br /> COWPLETION C -BOX <br /> Holding Temperature: cor.+PtEOMPLEnoN � <br /> Method: 07toond su ix0 r— <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No n. <br /> —n. <br /> it. <br /> SPOILS <br /> e <br /> Contamination Noted: ❑ Yes ❑NoP <br /> If yes,spoils storage Location: #bttad <br /> Covered: ❑ Yes El No <br /> +��n _ 8 <br /> gnvclpacx <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 33/ <br /> Depth to Water: <br /> Grout Material:Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> J�9Y(��S— ? !gq//ate <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> �f Filter Pack Type/Size: <br /> El Gravity MTremie Other: WkS� Type of Method: <br /> Water cement471b Water Cement 941b <br /> allons Bags stations Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3%MIX 5%mX <br /> 2.5 5 1 5 10 1 Bentonite per471b 1 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94lb 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 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 />