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SANAOAQUIN <br /> Environmental Health Department <br /> — <br /> COUNTY — <br /> °,c7r Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Zoo / Inspector: (i+/ CONSTRUCTION <br /> Facility Address:��zr_ '5_v31 <br /> � a <br /> Well Address: S /3: -+,:4 Total Depth: S s <br /> WP# 00g,6*1; ell#: 5 v SV �Svq Drilling Rig Type: pug ll,\ �'— <br /> Soil Boring#: <br /> Drilling Company: VMin 2"Annular EHD Seal Verified: eyes 11 No <br /> .,��.r <br /> Driller Onsite: G-6.1-114Screen Length From: To: <br /> Consultant: Filter Pack From:Q 57 To: <br /> Geologist: SZ>lo-j Bentonite From: To: K�S� S.5 <br /> Grout From:t9 o To: <br /> ��3�?I <br /> Public Water System Onsite: El Yes El No COMPLETION El � <br /> Stove Pipe L/Christie Box <br /> Domestic Well Onsite: ❑ Yes 1:1 No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: COMPLETION �tEnoN <br /> Method: Ground Surface <br /> Screening Method: Or«n <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> n. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> lxz' r_ <br /> If yes, spoils storage Location: slonad = B <br /> Covered: ❑ Yes ❑No <br /> g-vw Pack <br /> If yes, material: <br /> yI- <br /> = <br /> GROUTING or DESTRUCTION Total Depth: S : . <br /> Depth to Water: <br /> Grout Material: t%iC4_kc_y,,_cyN_j <br /> Gallons of Grout Used:^-0 MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> [Kell Installation Installation ❑Well Destruction Blank (c;-, Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: .- — (�-ra,..�•�.✓ <br /> ���� Filter Pack Type/Size: 3 <br /> [9' cavity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest 9Bags 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 /> 30 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 /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />