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SAN»J0A0UIN <br /> COUNTY Environmental Health Department <br /> cP/ Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> 1 / <br /> Date: 1( �� C�Inspector: vjCfykG- CONSTRUCTION <br /> Facility Address:` <br /> Well Address: Total Depth: Lf- 0 L r <br /> WP# 4U ,-45 Well#: 1A, 3 Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: U c( Min 2" Annular EHD Seal Verified: id Yes El No <br /> Driller Onsite: Screen Length From: Z 5 To: 1+0 <br /> Consultant: ` Filter Pack From: `Z 3 To: <br /> Geologist: Bentonite From: �_1 To: Z3 <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe hristie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: height <br /> SAMPLING nsov>=-GROUND <br /> Holding Temperature: COWLPTfON COMPLEnoN <br /> Method: Ground Surface <br /> Screening Method: grout ., <br /> ft. <br /> Verified Chain of Custody: El Yes E]No � ( ft <br /> SPOILS = .: <br /> '7 — n <br /> Contamination Noted: ❑ Yes ❑No =` <br /> If yes, spoils storage Location: ,b <br /> s*Ctan <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:z�-t� �5 : _ <br /> Depth to Water: n' <br /> Grout Material: <br /> ? MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: TU (2L '2" <br /> ❑Well Installation ❑Well Destruction Blank 2 7 Feet Screen_Feet <br /> Slot Size: 1 <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> LZsi \ <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Others-f" Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest uBags Thickest Thinnest .1 Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.821 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.S 3S 7 35 70 7 <br /> 20 40/l 8 40 80 8 <br /> e � S 1 j t'0 ss— `c�4 1 ro PZV 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />