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UIN <br /> s°�_ <br /> << �111 <br /> ? SA N.-J OAQ U I N Environmental Health Department <br /> " —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: S a a VI) Q CONSTRUCTION <br /> Facility Address: �qBl S �GI MQ,D L�t, YDI� <br /> Well Address: Total Depth: <br /> WP# 2.W-16a Well#: -6 Drilling Rig Type: <br /> Soil Boring#: <br /> Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: U( 01)Vn Nrra1 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 El No casing <br /> If yes, location and distance: height <br /> SAMPLING AEi;VE-GROUND <br /> Holding Temperature: COWF ENON coewt.ET110N <br /> Method: Ground Surtacv <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No �tt. <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No = <br /> C <br /> If yes, spoils storage Location: atoned <br /> aoc:cn — B <br /> Covered: ❑ Yes []No <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: rv,'b ft 2Fn• <br /> Grout Material: �4 <br /> Gallons of Grout Used: ti ��)� ql�,� w T rai MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation MWell Destruction �VYl0Y1`t"�2[V�(^J Blank Feet Screen Feet <br /> ❑Boring Installation []Boring Destruction Slot Size: <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 /> Fall Bags gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 /� ,1 `10 20 4 20 40 4 '�/`1�VV 11.� ' b6' ' J�I�V� W I4D gal(Dnf <br /> 12.5 25 5 25 50 5 ✓J <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 m w- i ��� 4�y a l wry s) p�q c �trc (J Z o t,(j-ed <br /> 20 40 s 40 so a <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.socehd.com <br />