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SA N J OAQ U I N Environmental Health Department <br /> I / COUNTY <br /> "-q-I��/ Greatness grows her,. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �I.5.1,m2w Inspector: MhatlimaVOh of CONSTRUCTION <br /> Facility Address: 5@,; W. gPX7.�oIVYfih ItOlt jLiVG <br /> Well Address: C y_w Total Depth: <br /> WP# 240MI01 Well#: Drilling Rig Type: <br /> Soil Boring#: DIPfly'm3,-OLA,41)to,-m-A- „ <br /> Min 2 Annular EHD Seal Verified: El Yes El No <br /> Drilling Company: <br /> Driller Onsite: jAcoh , 0 Vil) Screen Length From: To: <br /> Consultant: (_1C)0AtAn-reC, Filter Pack From: To: <br /> Geologist: 76 f'I'1 <br /> 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 /> SAMPLING A VE-GROUND <br /> Holding Temperature: COWLETION COMP=oN <br /> Method: Ground Sumacs <br /> Screening Method: Grout <br /> Verified Chain of Custody: ❑ Yes ❑No �tt• <br /> ft. <br /> tt. <br /> SPOILS = <br /> = o <br /> Contamination Noted: ❑ Yes ❑No = <br /> a <br /> If yes, spoils storage Location: slotted <br /> on <br /> Covered: ❑ Yes ❑No <br /> VRVW Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: X i <br /> Depth to Water: ZZt tt• — tt <br /> IF <br /> Grout Material: Wgaf CCrYtP,YI J <br /> Gallons of Grout Used: Tu1^ MATERIALS/DEVELOPMENT <br /> �� 3� a�allo nS <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation/*oring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity ',Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Baps gallons Bags <br /> Thickest Thinnest tlBags 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 /> 5 10 z 10 20 z Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 Note: DT PR Lj-(D}3,, CPIIA�I,o( dht� b�e, <br /> 12.5 25 5 25 50 5 'I\n S t a l(-e d <br /> 15 30 6 30 60 6 7�hh _1 <br /> 17.5 35 7 35 70 7 b� I'1!4 —Q) -C�2�v�.1 t° C,�[Ot O W <br /> to � <br /> zo ao s 40 80 s 1p� '�h 0.(l�ol SS I <br /> J-Y\t bov2 i►-. Ck IWLPSeCk 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 />