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N�,°UIN c\ <br /> � 10 SANI J0AQUIN Environmental Health Department-COUNTY-Greatness grove- <br /> Monitoring Well/Soil Boring Inspection Report on <br /> Date: 1 Inspector: CONSTRUCTION C�2 <br /> Facility Address: ow <br /> Well Address: Total Depth: �Q�\► 9� <br /> WP# 260Iq!3 Well#: Drilling Rig Type: <br /> Soil Boring#: PT ►�h. <br /> : ��'n(� U � Min 2 Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Compan �1'1 Il <br /> Screen Length From: To: <br /> Driller Onsite: �1�1 <br /> Consultant: Filter Pack From: To: q61 <br /> Geologist: Yin Bentonite From: To: Jay <br /> Grout From: To: JG�,�-y� <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 <br /> SAMPLING ABOVE-GROUND CHR_ <br /> Holding Temperature: COMPLETION coti+ LET71ON <br /> Method: Ground Sw'facs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �ft. <br /> tt. <br /> R. <br /> SPOILS = <br /> m <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: .tom <br /> sacion — � <br /> Covered: ❑ Yes El No = 1w <br /> Pack <br /> If yes, material: ^F <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: 131 I n n' <br /> Grout Material: hx(L Cewaink MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: .5 Al <br /> j - 1Casing Type: <br /> []Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation .Boring Destruction Bags iz Cement: <br /> METHOD USED 3/q{,,,d I ►�Z 611 311 Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill ;J Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity NrTremie ❑Other: Type of Method: <br /> Water ement 471b Water Cement 94lb <br /> allons Bags gallons Bags <br /> Thickest Thinnest ags Thickest Thinnest #Bags 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 1 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 1 60 6 <br /> 17.5 35 7 35 1 70 7 <br /> 20 40 8 40 1 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 />