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SHARON <br />g ' Environmental Health Department <br />COUNTY— <br />Greatness`rows here. �91.IF4R�� 9 <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 311ti fzoly Inspector: Ah4do5eA4 <br />Facility Address: 3261 W. 13gce.�.=514 Rci <br />Well Address: <br />WP# 60 3$0/3 Well#: <br />Soil Boring#: ,81, 2, 3k, <br />Drilling Company: <br />Driller Onsite: S-rrQ o if `PIIS <br />Consultant: b9� LTi%/.J E"47 t�fs <br />Geologist: f CeHr-t- <br />Public Water System Onsite: ❑ Yes NNo <br />Domestic Well Onsite: ❑ Yes �No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: Z01 <br />Depth to Water: 5 1 <br />Grout Material: Negl ter4e4f <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation ;Boring Destruction <br />METHOD USED ,3cY <br />Pressure Grout ❑Over Drill <br />❑ Gravity 'XTremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />RBags <br />Thickest Thinnest <br />NBags <br />2.5 5 <br />1 <br />5 <br />10 <br />1 <br />5 10 <br />2 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 25 <br />10 <br />5 <br />50 <br />5 <br />15 1 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 1 35 <br />7 <br />35 <br />70 <br />7 <br />20 1 40 <br />8 <br />40 <br />80 <br />8 <br />iKo ��►Ib� t,,,xa XH bars mi lbs <br />CONSTRUCTION <br />Total Depth: — <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length From: <br />Filter Pack From: <br />Bentonite <br />Grout <br />rnMPl PTInN <br />From: <br />From: <br />❑ Stove Pipe <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />ABOVE -GROUND CfiRIST 4= <br />COMPLETION COMPLE7lON <br />Ground Surfa" <br />grout <br />ft. <br />ft. <br />_ o <br />slotted <br />soon "— B <br />gravel pack <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: _ <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 3% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />