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nP n'-,, <br />SAN -JOAQUIN <br />—COUNTY — Environmental Health Department <br />Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date:'7/29 inspector: F m1VV- <br />Facility ddre s: R 111 'Aal I (,u LAA'e-' <br />Well Address: <br />WP# Well#: <br />Soil Boring#: t rl <br />Drilling Company:41-)V-11111n ed, <br />Driller Onsite: <br />Consultant: ^Ito r <br />Geologist: _ N&y-c i S So <br />Public Water System Onsite: <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <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 />❑ Yes ❑No COMPLETION ❑ Stove Pipe <br />❑ Yes 1-1 No <br />Verified Chain of Custody: ❑ Yes ❑No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: ly . ;to JC) <br />Depth to Water: lrl OV k , a0` - Vl o ✓u - <br />Grout Material: 1090a k CAkYLA-4 -f - <br />Gallons of Grout Used: 1 1 SQ 15 <br />❑Well installation ❑Well. Destruction <br />❑Boring Installation Aoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity %Tremie Other: u.` <br />l nose <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />T T <br />asov;`-�aDcnan - <br />co14S LaTion c -I M* -Box <br />CQWLEi CN <br />Cxaind Suixa <br />groat <br />ft. <br />— _ w <br />slanad <br />asc5on .f <br />_ -t_ <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 % Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7- <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 j T 209 468-34201 F 209 464-0138 1 www.socehd.com <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />5 <br />5 <br />1 <br />5 10 <br />1 <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 1 60 . <br />6 <br />17.5 <br />35 <br />i <br />35 1 70 <br />7 <br />20 <br />40 <br />8 <br />40 1 80 <br />8 <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />T T <br />asov;`-�aDcnan - <br />co14S LaTion c -I M* -Box <br />CQWLEi CN <br />Cxaind Suixa <br />groat <br />ft. <br />— _ w <br />slanad <br />asc5on .f <br />_ -t_ <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 % Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7- <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 j T 209 468-34201 F 209 464-0138 1 www.socehd.com <br />