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SKJOAQUIN <br /> COUNTY- Environmental Health Department <br /> cc � Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Sf rU / Inspector: 440'5 CONSTRUCTION <br /> Facility Address: ,r*9�1�1n�.i^a•?f� atS�a <br /> Well Address: Total Depth: <br /> WP# 00'39 Well#: Drilling Rig Type: <br /> Soil Boring#: C;&,.) -11 Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> �- Screen Length From: To: <br /> Driller Onsite: 7yar <br /> Consultant:c,.�,2 Filter Pack From: To: <br /> Geologist: Slo-ef 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 <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLE'rION COMPLETION <br /> Method: G=nd Surf xs <br /> Screening Method: o► <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No — <br /> C <br /> If yes,spoils storage Location: atoned <br /> on B <br /> Covered: ❑ Yes ❑No = g-vw ax* <br /> If yes, material: a <br /> T= <br /> GROUTING or DESTRUCTION Total Depth: �sSl <br /> Depth to Water: <br /> Grout Material: /►/Bta l�n.L y -f <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation 'Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity I Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> allons Bags gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest sBags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 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 L <br /> 15 30 6 30 60 6 �i (� <br /> 1 35 7 35 70 8 i e„ 146 <br /> 2.0 40 7 40 0 7 X�/' <br /> 10/16/2017 <br /> A7jk� <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />