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SH JOU N Environmental Health Department <br /> COUNTY— <br /> Greatness grows her­ <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: I U14 Inspector: �ilea►l. <br /> �dG CONSTRUCTION <br /> Facility Address: 503 W 6eL4)c-4-".4Ak,0k <br /> Well Address: Total Depth: <br /> WP# 7,4001&1 Well#: Drilling Rig Type: <br /> Soil Boring#: b 1; P A --w- <br /> Drilling Company:• aC 1 fi Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: Cl e{- v; <br /> Screen Length From: To: <br /> Consultant: „iS„i I kkK�S Filter Pack From: To: <br /> Geologist: ut � �ti <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 El No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COWLETION cCN <br /> Method: Ground Sulac* <br /> Screening Method: I grout <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> ft. <br /> —ft. <br /> SPOILS M; <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: slotted <br /> axon <br /> Covered: ❑ Yes ❑No = 9­1 <br /> Pack <br /> If yes, material: «x <br /> GROUTING or DESTRUCTION Total Depth: i x3 <br /> x <br /> Depth to Water: 1-7. C1 tt• <br /> Grout Material:14PGA- r4o" r.,s1 <br /> Gallons of Grout Used: 'Y l� S CAI MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation [;Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ;�%oring 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 /> allons Bags gallons Bags <br /> Thickest Thinnest uBags Thickest Thinnest »Bags 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 DE P.4 6 curry �ti, 3 s' ,d 7 12.5 25 5 25 50 5 c�.,i� Q <br /> 15 1 30 1 6 30 60 6 CG4wlv1 ii-., I-& Col. <br /> T14P cA,,'(I^-3 <br /> 17.5 35 7 35 70 7 CCU 1f+1 H <br /> 20 40 8 40 80 8 J� C�! rv'p '_Ptnn ripc" G(PP0 <br /> !ev <br /> y <br /> 3,5 IVa�5 uspv) ✓ 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 />