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;2 SAN JOAQUIN <br />COUNTY— <br />Environmental Health Department <br />Greotness grows her,, <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 10 Inspector: 'Zv a Por�1110 CONSTRUCTION <br />Facility Address: JA-�IhrpV <br />Well Address: IcL}LA,rcf Total Depth: <br />WP# 00 _9-}. 39 2 Well#: Drilling Rig Type: <br />Soil Boring#: '1,.., Min 2" Annular EHD Seal Verified <br />Drilling Company: Kraz&., t 49S&.- C4 AAS lj1 acl Screen Length From: <br />Driller Onsite: Q4gr,s <br />Consultant: Filter Pack From: <br />Geologist: y.9, Bentonite From: <br />Grout From: <br />Public Water System Onsite: ❑ Yes 00 <br />Domestic Well Onsite: ❑ Yes *0 <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 />Cprlll C <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 29} + <br />Grout Material: Ne6,in C,2ov►,e4-,6 <br />Gallons of Grout Used: <br />[]Well Installation ❑Well Destruction <br />❑Boring Installation XBoring Destruction <br />I%APTunn i icFn <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity YTremie ❑Other: <br />Water <br />allons <br />Cement 47 lb <br />Bas <br />water <br />eallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />9Bags <br />Thickest Thinnest <br />"Bags <br />s <br />1 <br />5 10 <br />1 <br />s <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 />B <br />40 80 <br />8 <br />COMPLETION ❑ Stove Pipe <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />-ft. <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 />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sacehd.com <br />