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/P°ulti" <br /> SANJOAQUIN <br /> —COUNTY- p <br /> Environmental Health Department <br /> Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: f,V-Am V0 CONSTRUCTION <br /> Facility Address: S- 120WO K q "h <br /> Well Address: Total Depth: <br /> WP# Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company:EY1M �Sb 1� Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: °LU) a(1V1�1'll'11t Q Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> tj 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: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWFLETION comPLEncN <br /> Method: Ground Sulac* <br /> Screening Method: grow <br /> Verified Chain of Custody: ❑ Yes ❑No -n- <br /> tt. <br /> ft. <br /> SPOILS = <br /> = m <br /> Contamination Noted: ❑ Yes El No _= <br /> C <br /> If yes,spoils storage Location: stottod <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:_ _ <br /> Depth to Water: 1J 2,1 <br /> Grout Material: �k MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Y�lO�ilh�l�j Casing Type: <br /> ❑Well Installation Well Destruction Blank Feet Screen Feet <br /> WW <br /> Slot Size: <br /> ❑Boring Installation ❑ (, <br /> Boring Destruction � MWM <br /> ^I' Bags of Cement: <br /> METHOD USED �l1A Bags Sand/Gravel: <br /> ❑Pressure Grout *ver Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity Premie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest 9Bags 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 <br /> 10 20 4 20 40 4 / \^ <br /> 12.5 25 5 25 50 5 �Z J ��1�J VVA <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 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.sacehd.com <br />