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NpuiN�, <br /> SAN �J0A0UIN Environmental Health Department <br /> COUNTY - <br /> cr "' Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 6 'Li7la Inspector: CONSTRUCTION <br /> Facility Address:_ -731 <br /> Well Address: Total Depth: 6--T) <br /> WP# ()Q�1[03 3 Well#: Drilling Rig Type: ce-7 <br /> Soil Boring#: Cii7 / Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Yllc(d�(�iYtw <br /> Driller Onsite: QoScreen Length From: To: <br /> �/�c.f <br /> Consultant: Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes L1 No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLINGABOVE-GROUND <br /> Holding Temperature: CO&PLETION CCOMPTM toN <br /> Method: Ground Surf"' <br /> Screening Method: grow <br /> Verifiied Chain of Custody: ❑ Yes ❑ r <br /> No —`--n' <br /> n. <br /> tt. <br /> SPOILS a. <br /> e <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: slotted _ B <br /> an <br /> Covered: ❑ Yes ❑No <br /> g-vW pack <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: q <br /> Grout Material:—k"A'r 6ewLLe MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑ V�l <br /> Boring Installation Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity &Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allows Bas eallons BaRs <br /> Thickest Thinnest NBa Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 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 8 <br /> 10/16/2017 <br /> 5 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />