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SAN JOAQUIN <br />'a p�''''1Environmental Health Department <br />ik:�l"__ ----COU NTY----- <br />e <br />cgcri' Greatness grows herc. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /2//Z It 7 Inspector: 9-lqwR <br />CONSTRUCTION <br />Cement 471b <br />Bas <br />Facility Address//97ini <br />Gt2 ll <br />, <br />31 <br />#Bags <br />Well Address: de2q*t- <br />4,et�e-. <br />Total Depth: <br />5 <br />WP# DD 37(07/ <br />� <br />Well#: <br />Drilling Rig Type: <br />5 <br />Soil Boring#: C <br />Drilling Company: �'Q/- <br />�''� <br />• picsl� %IEG�•rt° i�r <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Driller Onsite: <br />7.5 <br />Screen Length From: <br />To: <br />Consultant: <br />3 <br />Filter Pack From: <br />To: <br />Geologist: �o� <br />Li �`'zaic_ <br />Bentonite From: <br />To: <br />25 <br />5 <br />Grout From: <br />To: <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />cnnnoi inir_ <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTI N Total Depth: �3l • 5 - <br />Depth to Water: 4A7 -- <br />Grout Material: 44CatA_ Ce.4Ie.. — <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />El Boring Installation IRBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity IXTremie ❑ Cit her: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />4Bags <br />2.5 <br />5 <br />1 <br />5 10 <br />1 <br />5 <br />10 <br />2 <br />10 20 <br />2 <br />7.5 <br />15 <br />3 <br />15 30 <br />3 <br />10 <br />20 <br />4 <br />20 40 <br />4 <br />12.5 <br />25 <br />5 <br />25 50 <br />5 <br />15 <br />30 <br />6 <br />30 60 <br />6 <br />17.5 <br />35 <br />7 <br />35 70 <br />7 <br />20 <br />40 <br />8 <br />40 80 <br />8 <br />ft. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />ft. <br />Blank Feet Screen 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 />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 />