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SA N.J OAQ U I N Environmental Health Department <br /> COUNTY <br /> c�ur� Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> . Date: V41L.0 Inspector: 91. nn l� CONSTRUCTION <br /> Facility Addressiscl 0. l-t./;tsc,C�� )PC," � (9C/-1�3s <br /> Well Address: Total Depth: -1 Q <br /> WP#1(,&c Gib Well#: Drilling Rig Type: <br /> Soil Boring#: V11'I-LG -,GZ- Min 2" Annular EHD Seal Verified: Yes ❑No <br /> Drilling Company: Qce&' wlC <br /> Driller Onsite: yic rK Screen Length From:tj L S To: 1.7,45 <br /> Consultant: 4 Cj I ey 4- A l-(ri dd 144L Filter Pack From:t�3 .5 To:��� <br /> Geologist: WLu acts Bentonite From: �S To: L Z� <br /> -� Grout From: 11 Z 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 ABOVE-GROUND <br /> Holding Temperature: COWLETION COWLEMoN <br /> Method: G=nd Surface <br /> Screening Method: crl«n <br /> Verified Chain of Custody: ❑ Yes ❑No -`--n' <br /> ft. <br /> SPOILS = <br /> — o <br /> Contamination Noted: ❑ Yes ❑No = r <br /> If yes, spoils storage Location: ■tome <br /> sac on — <br /> Covered: ❑ Yes ❑No - ate* <br /> If yes, material: '< <br /> GROUTING or DESTRUCTION Total Depth: 1?Z-7Z t = <br /> Depth to Water: `LGt n n' <br /> Grout Material: 1I&Q+ ceww e N MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 2GCG a u <br /> Q Casing Type: <br /> L)Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation El Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity �7remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest 9Bags 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 <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 www.sacehd.com <br />