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SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> , Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: /0/7 4 Inspector: Lelilley CONSTRUCTION <br /> Facility Address 'ZAM $FA ox-r K,n <br /> Well Address: Total Depth: <br /> WP# ' -140 Well#: Drilling Rig Type: <br /> Soil Boring#:_&L%/ -06 -0 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Qrt.,tm.• <br /> Driller Onsite: fprq t Screen Length From: To: <br /> Consultant: 9,C4�4� t„s Filter Pack From: To: <br /> Geologist:_ /Q W vl VJ O Vf Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: R height <br /> SAMPLING ABOVE-01FIOUND CHswryeox <br /> Holding Temperature: COLPLETION COMPLETION <br /> Method: Ground <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑Non• <br /> n. <br /> SPOILS — <br /> e <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: <br /> ,toned <br /> wrlon <br /> Covered: ❑Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Delpth:5$��t =_ 1 <br /> Depth to Water: <br /> Grout Material: Vl;Cad C e&AA.04/a MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: — t 3 5 v a Is Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Dover Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags eallons Ba s <br /> Thickest Thinnest 4Bags Thickest Thinnest NBags Bentonite/Cement Mix 3% Mix 5%MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonile per 94lb 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 5o 5 .M/ r•'�{,�,� t/'Im%53'cn /C /Ca.L Gw�6 <br /> 17.5 35 7 35 70 7 4�If ✓• lN'Sp ec/r-- p C✓r�. <br /> 20 40 a 40 e0 e Gc k5�6� bcV i v *F,u r'•"`/ 1 N P*1j)rc1,•4•-t <br /> 2 1. �9S t.t��vi 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 I www.sFcehd.com <br />