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SA NJ0AQ U I N <br /> Environmental Health Department <br /> —COUNTY— <br /> �'�scrr/ Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �j�j Inspector: K lbacterxI CONSTRUCTION <br /> Facility Address: 6401 ICrtx 6n MPanC� C."'V' Qd. <br /> Well Address: Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#:C,?A �1'Go V;2,* a -144•2 ikS"38 <br /> Drilling Company: <br /> *{6.a� Min 2"Annular EHD Seal Verified: 11 Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <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: COMPLETION cccMPPLErioN <br /> Method: t:3=nd SLeacs'—+---��" <br /> Screening Method: groLd <br /> Verified Chain of Custody: ❑ Yes El No tL <br /> Tt. <br /> t�. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No r = <br /> If yes,spoils storage Location: <br /> stoned x <br /> sac,on <br /> Covered: ❑Yes ❑No w' <br /> Qrwol Packs <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 503 <br /> Depth to Water: {� 3�j� � 3$ Z ttI F IFn- <br /> Grout Material: Neck Cemem 3q <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation tk.BSlot Size: <br /> oring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ZTremie ❑Other: - Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gall ons Bags <br /> Thickest Thinnest #Bags 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 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 0 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 www.socehd.com <br />