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SAN' JOAQUIN <br />COUNTY --- <br />Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 7111 / / V Inspector: <br />Facility Address: /7,-kfd aAlY- <br />Well Address: <br />WP#00'ig v _Well#: <br />Soil Boring#: gl(o✓ h <br />Drilling Company:4- 14.% <br />Driller Onsite: /47<le- <br />Consultant: /< <br />/e,11Fh%a>/ei , zwG <br />Geologist: _ a ez <br />Public Water System Onsite <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />❑ Yes 11 No COMPLETION ❑ Stove Pipe <br />Domestic Well Onsite: ❑ Yes ❑No <br />If yes, location and distance: <br />CANAPI IN(' <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes 11 No <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />—r— casing <br />♦ height <br />ABOVE -GROUND CHRISTY-BOX <br />COKVLET10N COMPLETION <br />Ground SLrfwv �--. <br />grout <br />n. <br />n. <br />n. <br />SPOILS = <br />_ - e <br />Contamination Noted: ❑ Yes ❑No — <br />If yes, spoils storage Location: slotted <br />a*cson <br />Covered: ❑ Yes ❑ No <br />t _ <br />If yes, material: $(,Z, 3 - <br />GROUTING or DESTRUCTION Total Depth: 3c- BL1,S, & <br />Depth to Water: O Gu% i37, g tot n - <br />Grout Material: E3,1 Z&1 <br />Gallons of Grout Used: MATERIALS/DEVELOPMENT <br />_ basing Type: <br />❑Well Installation ❑Well Destruction ��! 31ank Feet <br />Slot Size: <br />❑Boring Installation Boring Destruction gags iz Cement: <br />METHOD USED Bags Sand/Gravel: <br />(Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />❑ Gravity ❑Tremie k0ther: 42"e- �f I Type of Method: <br />�1 <br />Screen Feet <br />Bentonite/Gement Mix 3% Mix 3% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />�N z -g "( 71 10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />ater <br />allons <br />ent 4 fb <br />Ba <br />Water <br />Fall ons <br />Cement 941b <br />BaFs <br />Thi <br />hinnest <br />XBags <br />Thickest Thinnest <br />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 />20 <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 />Screen Feet <br />Bentonite/Gement Mix 3% Mix 3% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />�N z -g "( 71 10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />