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%. c°�Z, SAK)JOAQUIN <br /> Environmental Health Department <br /> —COUNTY— <br /> Greatness I;4� P� grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: (4312114 Inspector: .S-trn 1/aM1a CONSTRUCTION Mw�' <br /> Facility Address: S.nqo y`1 h l b <br /> Well Address: T Total Depth: 17, V\)e H,p�a'M <br /> WP# H Well#: / �'�' Drilling Rig Type: lAtAp(lsl Ann 193AACe <br /> Soil Boring#: <br /> Company: Min 2" Annular EHD Seal Verified: �Yes ❑No <br /> Drilling p Y: 'MK I� Vin0� t i <br /> � <br /> Driller Onsite: � •G Screen Length From: � To: <br /> Consultant: Filter Pack From: r(1�' To:� <br /> Geologist:— „�hY�S�`�h(/1� Bentonite From: To: <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 /> WT _WWT fIJh <br /> SAMPLING ABOVE-GROUND rY1()U hY <br /> Holding Temperature: tAh' LETION cOMPLEncN <br /> Method: Ground Suwiaes 'T <br /> Screening Method: grout <br /> Zst ,� I <br /> Verified Chain of Custody: El Yes El No <br /> n' Zb'2$ Ben'tr, <br /> n. <br /> tt. <br /> SPOILS = <br /> O <br /> Contamination Noted: El Yes ❑No <br /> If yes, spoils storage Location: � eLfn slonad <br /> sacson _ <br /> Covered: ❑ Yes ❑No = gn,,a l <br /> If yes, material: 2 <br /> GROUTING or DESTRUCTION Total Depth:* Q( Seal <br /> Depth to Water: 3 6• <br /> Grout Material: �at <br /> Gallons of Grout Used: .aa, ��Q{)J MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> )I.Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 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 <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.sucehd.com <br />