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' r <br />` SAN JOAQUIN <br />I"4 —COU NTY-- <br />cq�rr.: Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 12 he I r+ inspector: _-Lwn0` <br />Facility Address: <br />Well Address: qp 2.0 k1 -j to t, Ot-jo <br />WP# 00 37;r 6's Well#: _4 <br />Soil Boring#: <br />Drilling Company: _ K ;til„ S SS k►tih { FV,% 3 <br />Driller Onsite: Klf_4i, Gyy;s <br />Consultant: <br />Geologist: <br />Public Water System Onsite: ❑ Yes P&Io <br />Domestic Well Onsite: ❑ Yes VNo <br />If yes, location and distance: <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth: 49 2 f� <br />Depth to Water: g 4:4 - <br />Grout Material: q4i.QS <br />Gallons of Grout Used: 2 t/2 6V LSoIbs ��►) <br />❑Well Installation Well Destruction <br />❑Boring Installation ❑Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />1t Bags <br />Thickest Thinnest <br />uBags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />25 50 <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 80 <br />8 <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD 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 />IFOT height <br />ABOVE -GROUND CrAI.m-aox <br />COMPLETION COMPLETION <br />Ground Surfw* <br />grout <br />ft. <br />ft. <br />ft. <br />: <br />= e <br />_ o <br />slotted _ Z <br />Bacton <br />_ = gravai Pads <br />ft.I F=I Ftt- <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 1.41 2.47 <br />Bentonite per 94 Ib 1 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.s4cehd.com <br />