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V A 1\d o A Q V I <br /> Environmental Health Department <br /> COUNTY--- <br /> \\Fq Greatness grows here. <br /> Mon'itloring Well/Soil Boring Inspection Report <br /> Date: (7 Zq 12D Inspector: U)UK,, CONSTRUCTION <br /> Facility Address: 14400 s t :te <br /> Well Address: d*7;, &oLSe ra t' 16'-( ° " 'fioteal Depth: 0'>2 5 (0 <br /> WP# C> 4 O !a 03 _Well#:T—L� Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: 4 Screen Length From: To: -2.5 <br /> Filter Pack From: J To: <br /> Consultant: v. — ` <br /> Geologist: rS {- Bentonite From: 60 To:— 17-�j <br /> Grout From: To: 5' <A_ <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CO&FLETION COMPLETION <br /> Method: Groundsudacs f <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �ft• <br /> it. <br /> tt. <br /> SPOILS = <br /> ZI — a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: slotted <br /> sac�on = B <br /> Covered: ❑ Yes ❑No <br /> giravwpack <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: I'Z n- — n• <br /> Grout Material: �Q ( MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> KWell Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation ❑Boring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: Z J '?I Q S r5�s <br /> Type/Brand of Bentonite: w•-' -f- <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity k remie ❑Other: Type of Method: <br /> Water cement 471b Water Cement 941b <br /> allons Bags eallons Bags <br /> Thickest Thinnest aBags Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 3% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 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 <br /> 15 30 6 30 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 />