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S A N 10 A Q U I N <br /> Environmental Health Department <br /> o I'.. `! —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1 O- nspector: CONSTRUCTION <br /> Facility Address: <br /> Well Address: t/T�°�,al Depth: <br /> WP# u�'�4b�-- Well#: -0 �Q�`�rEng Rig Type: <br /> Soil Boring#: (— <br /> Drilling Company:��„cJ�Vi�+�„��((i Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: V� 1) Screen Length From: To: <br /> Consultant: 5kA Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes C�7No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes No casing <br /> If yes, location and distance: / +► height <br /> SAMPLING ggpyE.dapUNp <br /> Holding Temperature: CONFLEr1QN C�OMPPLETiiON <br /> Method: Ground Suiacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> tt. <br /> ft. <br /> SPOILS <br /> fir= . <br /> Contamination Noted: ❑ Yes El No 7 = <br /> If yes,spoils storage Location: <br /> slotted <br /> ssc�on ?V — <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: =_ <br /> Depth to Water: P— ft. <br /> Grout Material: T MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Casing Type: <br /> ❑Well Installation OWell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> El Pressure Grout C�lOver Drill Filter Pack Type/Size: <br /> ❑ Gravity TTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94lb <br /> allons Bags Rallons Bags <br /> Thickest Thinnest #Bags 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 z Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 50 5 <br /> 15 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 00 0 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.s'cehd.com <br />