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Q : SAN.JOAQUIN <br />" Li K' COUNTY- <br />°,'-ngcr�P', Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: J Z3 l Inspector: /144&4-Ftit <br />Facility Address: 2/11 Q-Y'v�e <br />Well Address: <br />WP# Gl936635" Well#: <br />Soil Boring#: t 2 a3r <br />Drilling Company: <br />Driller Onsite: /4 C' <br />Consultant: �! <br />Geologist: Nal el- sem <br />CONSTRUCTION <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 />Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe <br />Domestic Well Onsite: ❑ Yes ❑No <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 />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />❑ Yes ❑ No <br />Covered: ❑ Yes ❑No i <br />If yes, material: <br />13z 1 O <br />GROUTING or DESTRUCTION Total Depth: X33 ip' <br />Depth to Water: '� 3 <br />i Ll I S' <br />Grout Material: /Ilev, l-toe,",�,, f <br />Gallons of Grout Used <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation CKBoring Destruction <br />METHOD USED <br />,Pressure Grout ❑Over Drill <br />❑ Gravity XTremie I3d0ther: rk'& nt�J <br />❑ Yes ❑ 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 />8 it, -Ave f—q <br />/ <br />`,O .1 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 <br />10/16/2017 <br />www.s'cehd.com <br />ater <br />gallons <br />ment 471b <br />Bas <br />Water <br />allons <br />Cement 941b <br />Bags <br />Th <br />hinnest <br />Bags <br />Thickest Thinnest <br />ttBags <br />2.5 <br />5 <br />1 <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 />1 25 <br />5 <br />1 25 50 <br />5 <br />15 <br />L 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 />❑ Yes ❑ 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 />8 it, -Ave f—q <br />/ <br />`,O .1 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 <br />10/16/2017 <br />www.s'cehd.com <br />