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SAN :JOAQUIN <br />—COUNTY---. <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 12,112 / 7 Inspector: 4�;a4__? .w19 CONSTRUCTION <br />Facility Address: //-377 ee_s*4' <br />Well Address: cfbr.e_ ' Ag'qae ai. Total Depth: 32 <br />WP# 0037&7/ Well#: Drilling Rig Type: <br />Soil Boring#: Min 2" Annular EHD Seal Verified <br />Drilling Company:/"4 <br />Driller Onsite: Screen Length From: <br />Consultant: Filter Pack From: <br />Geologist: ViYn'1 L1t7_-4_ Bentonite From: <br />Public Water System Onsite <br />Domestic Well Onsite <br />If yes, location and distance: <br />CAI\API Inlr, <br />❑ Yes ❑No <br />❑ Yes ❑No <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted <br />If yes, spoils storage Location: <br />Covered: <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />If yes, material: <br />i <br />GROUTING or DESTRUCTION Total Depth: �2 <br />Depth to Water: rlAG_ <br />Grout Material: Xee,, CP�C�1� <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />El Boring Installation ZBoring Destruction <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity UTremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />4Bags <br />Thickest Thinnest <br />4Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />so <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />Grout <br />COMPLETION <br />From <br />❑ Stove Pipe <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <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 />ft. <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% 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.s'cehd.com <br />