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SAN-JOAQUIN <br />" i> ..—COUNTY ---- <br />Greatness grows heit-. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 7/15 /T Inspector::Sl6�44 <br />Facility Address: lv-�,uo w• Sc4,,t-6 /e <br />Well Address: <br />W P# Wel I#: <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: la zaN- <br />Geologist: def JL4 <br />V <br />Public Water System Onsite: ❑ Yes El No <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 />conn C <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes ❑ No <br />if <br />GROUTING or DESTRUCTION Tota% Dept (0 <br />Depth to Water: A&P ,�L6t4 d v4!�' <br />Grout Material: Ale-e,,l �' Piro ►� <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation ❑Boring Destruction <br />METHOD USED <br />LAPressure Grout ❑Over Drill <br />❑ Gravity 297remie ❑Other: <br />r nKICTDI Ir'Tinhl <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Screen Length <br />at <br />s <br />ent 47 <br />s <br />Water <br />gall ons <br />Cement 941b <br />Bags <br />Thickest <br />Thinnest <br />k Bags <br />Thickest Thinnest <br />b Bags <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 />10 <br />4 <br />20 40 <br />4 <br />12.5 <br />25 <br />5 <br />25 so <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 />r nKICTDI Ir'Tinhl <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑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 />height <br />ABOVE -GROUND CHRI.m-Box <br />COMPLETION COMPLETION <br />Ground surrx. <br />proud <br />ft. <br />ft. <br />o <br />= o <br />slotted = 8 <br />aeon <br />gravel Pads <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 />nti, X r/S-111 1�e <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s4cehd.com <br />