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c. SAN IOAQUIN <br />j COUNTY— <br />`.�<;";�' Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 31,/) f! Inspector: ^114S -66w4 <br />Facility Address: '2111 LW4K4S .bR.'v"e- <br />Well Address: <br />WP# M37igz Well#: <br />Soil Boring#: 136:,13,1 <br />Drilling Company: Vje&� C04s+ 5c fjor44'0A <br />Driller Onsite: <br />Consultant: C.ON-fir <br />Geologist: Narcl'tse <br />Public Water System Onsite: ❑ Yes El No <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 ❑No <br />Total Depth:_ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />From: <br />Filter Pack <br />From: <br />Bentonite <br />From: <br />Grout <br />From: <br />COMPLETION ❑ Stove Pipe <br />❑ Yes ❑No <br />❑ Yes ❑No <br />❑ Yes ❑ No 12 <br />GROUTING or DESTRUCTION Total Depth: I5r <br />Depth to Water: Ake 6rro.4,d L-�u4eh <br />Grout Material: cerrleowt— <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />[]Boring Installation ABoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity IjVremie ❑Other: <br />Water <br />allons <br />Cement 47 lb <br />Bas <br />Water <br />Rallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />rr Bags <br />Thickest Thinnest <br /># Bags <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 />5 50 <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />casing <br />height <br />—w—w— <br />ABOVE-GROUND Gi�IISTY 30X <br />COMfPLET10N cowL=71oN <br />crouna sures. <br />grout <br />ft. <br />ft. <br />`K - <br />_ - o <br />— _ o <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 />ft. <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 />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />y L'arx l 10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.smcehd.com <br />