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Environmental Health Department <br /> SQN ��QQ��N <br /> +� COUNTY— <br /> �z Greatness grows her. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 5/ Inspector:,S t nc cz ► CONSTRUCTION <br /> Premise Address: ggqq 6 . ALAnrim Zo. M n.Nncca <br /> WP#: W?s C,O 16 7Al Total Depth: <br /> Well#: sVr- - t 1 Drilling Rig Type: <br /> Soil Boring#: - Min 2"Annular Sea Verified: ❑ Yes El No <br /> Drilling Company: Vmwceomc <br /> Driller Onsite: Toitear O¢uEL A � Screen Length Fr m: To: <br /> Filter Pack From: To: <br /> Consultant: Gan Sypamc <br /> Geologist:�.4Atj 'JQsC-Ez <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION El Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No asing <br /> If yes, location and distance: iiaight <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CO�"P��N COOMtPLETION <br /> Method: nd S`>nl"'7— <br /> Screening Method: groul <br /> Verified Chain of Custody: ❑ Yes ❑No n' <br /> tt. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes []No = e <br /> If yes, spoils storage Location: a►ottad <br /> axZon <br /> Covered: ❑ Yes El No = g-vol> <br /> ack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:A/ FF — <br /> Depth to Water: n- — n- <br /> Grout Material: �e,aT«,n�D Ce.Arb&; It MATERIALS DEVE OPMENT <br /> Gallons of Grout Used: &I GAL.. <br /> Casing Type: <br /> %Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑ Slot Size: <br /> Boring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Si e: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> water Cement 471b water Cement 941b <br /> gall Bags zallons Bags <br /> Thickest Thinnest 11Bags Thickest Thinnest bBags <br /> 2.5 s 1 5 10 1 Bentonite! ement Mix 3% Mix 5% Mix <br /> 10 2 10 20 2 <br /> 7.5 15 3 15 30 3 Bentonitep r 47 Ib 1.41 2.47 <br /> 10 20 4 20 40 4 1 Bentonite p r 94 lb 2.82 4.7 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 1 60 6 <br /> 17.5 35 7 35 1 70 7 <br /> 20 40 8 �F40 1 80 8 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />