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SANJOAOUIN <br />5 T <br />—COUNTY— <br />CA L <br />. Greatness crows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /Z Inspector: Z4�y&w <br />Premise Address: -75V w- JCi e /ZE <br />W P#: X373 <br />Well#: <br />Soil Boring#: 1 <br />Drilling Company: -7.44 <br />Driller Onsite: 14ndjf <br />Consultant: kjQ,I&. e 011, 744 <br />Geologist: <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <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 06o <br />❑ Yes XNo <br />❑ Yes ❑No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />GROUTING or DESTRUCTION/Total Depth:_ <br />Depth to Water: // e <br />Grout Material: — Nea C�h-avz <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation XBoring Destruction <br />METHOD USED <br />;pressure Grout ❑Over Drill <br />❑ Gravity XTremie ❑Other: <br />Water <br />allons <br />From: <br />cement 471b <br />Bas <br />Mater <br />eallons <br />From: <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />Bags <br />Thickest Thinnest <br />PBags <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 15- <br />25 <br />25 <br />50 <br />5 <br />15 <br />30 <br />30 <br />SD <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 />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular Seal Verified: ❑ Yes El No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />COMPLETION ❑ Stove Pipe ❑Christie Box <br />casing <br />height <br />c4in�$ovE- i�L JctF mrY-lox ' <br />bOMPL.ErION CC PL.E iON <br />C-.=nd Sadaca <br />VIA proud <br />ft. <br />tt. <br />ft. <br />= o <br />_ — o <br />zfottnd � ' = c <br />asc3an — <br />3 <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 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2:82 4.7 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />