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' (y"P°u'"��� SANsIOAQUIN <br /> COUNTY Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:0 Inspector: �.TVUfMMGv6hqJ41 CONSTRUCTION <br /> Facility Address: 56961 P14oa lk) dYD(e,"n <br /> Well Address: Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: "7 (a) Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: D6 VkQ <br /> Driller Onsite: M���� Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: M,Y,- Ats pa 12 S Geologist: Bentonite From: To: <br /> �iY1l�lS�Oh�1Glr <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND CHR�M_ <br /> Holding Temperature: COWFLErtON CCOMPtEnoN <br /> Method: G=nd Surface <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes El No �ft. <br /> ft. <br /> —ft. <br /> SPOILS = <br /> — _ o <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: clod <br /> section — <br /> Covered: ❑ Yes ❑No = g-9 <br /> Pack <br /> If yes, material: >x — <br /> GROUTING or DESTRUCTION Total Depth: Lit IF IF <br /> =_ <br /> Depth to Water: 300.25I <br /> Grout Material: N e f MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ZB a 1tons Casing Type: <br /> []Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation)KBoring 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 /> gall s Bags Pallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest ttBags 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 /> z 2s s 25 so s15 Z �j(�(�S 0 � <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 �'1 10 f..}}/1 i rf �o <br /> 20 40 8 40 80 8 T ` V �:,u T"V� �E^'`�/\ ��"'�� �� <br /> VWV 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.socehd.com <br />