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SAKdOAQUIN <br /> Environmental Health Department <br /> - COUNTY— ys <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 412'A702b Inspector: "-34Ai/1CL5 _ CONSTRUCTION <br /> Facility Address:_ -5%bf) OJ 6rartt.'j a gfA. w" <br /> Well Address _ J Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: M5 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: �^wi <br /> z U, J Screen Length From: To: <br /> Driller Onsite: -�F1t`�,,,, <br /> Consultant: , Filter Pack From: To: <br /> 1���" <br /> Geologist: i11U�.y� N4a((i� Bentonite From: To: <br /> (�Qi'• <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El 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: COt"��ION COMPtEnoN <br /> Method: Ground Surface <br /> Screening Method: auYS procrt <br /> Verified Chain of Custody: ❑ Yes ❑Nod <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No = r <br /> If yes,spoils storage Location: slotted = <br /> G SA do05 ffuW al, mon <br /> Covered: ftka Un ❑ Yes ❑No = g,,,lw Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: : <br /> Depth to Water: Wi ffn- n' <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: e-a Q <br /> .� <br /> 11 Casing Type: <br /> ❑Well Installation ❑Well Destruction -0 \,,,,,,wi-o Blank Feet Screen Feet <br /> El Boring Installation Boring Destruction `rpt Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> SIMQZ� Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill I <br /> T0. Filter Pack Type/Size: <br /> ❑ Gravity ZTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest RBags Thickest Thinnest bBags 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 1 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 /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />