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SANJOAQUIN <br />Environmental Health Department <br />—COUNTY <br />`csr,oa Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: W.2k Inspector: -Zur,ct -&,Acer Qo c};tiC <br />Facility Address: Lc� k-► rna iZA <br />Well Address: 1-c-VjAy-c4 Rc- <br />WP# 6 03}39 2 Well#: <br />Soil Boring#: 134 <br />Drilling Company: krcrZc,.,n to S;dC� t h( <br />Driller Onsite: CAriS <br />Consultant: <br />Geologist: y <br />Public Water System Onsite: ❑ Yes <br />Domestic Well Onsite: ❑ Yes <br />If yes, location and distance: <br />0 <br />P <br />XN0 <br />SAMPLING <br />Water <br />gallons <br />Holding Temperature: <br />Thickest Thinnest <br />Method: <br />Thickest Thinnest <br />Screening Method: <br />2.5 <br />Verified Chain of Custody: ❑ Yes <br />El No <br />SPOILS <br />1 <br />Contamination Noted: ❑ Yes <br />El No <br />If yes, spoils storage Location: <br />10 20 <br />Covered: ❑ Yes <br />❑No <br />If yes, material: <br />3 <br />GROUTING or DESTRUCTION Total Depth: 2® 4 - <br />Depth to Water: Wnyx#2_ <br />10 <br />Grout Material: Nccv�_ CA*_L "_k. <br />4 <br />Gallons of Grout Used: <br />4 <br />❑Well Installation ? Well Destruction <br />25 <br />❑Boring Installation ❑Boring Destruction <br />25 50 <br />METHOD USED <br />15 <br />❑Pressure Grout ❑Over Drill <br />6 <br />❑ Gravity XTremie ❑Other: <br />6 <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 /># Bags <br />2.5 <br />5 <br />CD <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 />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />rnimm FTInIV <br />From: <br />From: <br />From: <br />From: <br />❑ Stove Pipe <br />❑ Yes ❑ No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />/ABOVE -GROUND CHR STY4M <br />00hPLETION ccMPt.EncN <br />Ground Svlan <br />grout <br />ft. <br />tt. <br />k° <br />— o <br />— w <br />= e <br />0 <br />slonad = Z <br />socson — B <br />g-1 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 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 />