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SAN JOAQUIN <br /> ----COUNTY----- <br /> Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> 8/ 3%a <br /> Date: )W=y 141V Inspector: Au e&.»- CONSTRUCTION d <br /> Facility Address: � <br /> Well Address: 3/2i Pw df />j- Total Depth: , _ <br /> WP# qv.3g�� Well#: Drilling Rig Ty /rpe: � �lit�- <br /> Soil Boring#: & z, 3 Min 2"Annular EHD Seal Verified: ❑ Yes EI No <br /> Drilling Company: Z��eico— Gs.0 <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: 7609ee--,Ikc Filter Pack From: To: <br /> Geologist: /9J/g Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: OOWPLETION CCOOMPLEnON <br /> Method: G=nd Sudw* <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> tt. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: slotted <br /> sacton — B <br /> Covered: ❑ Yes ❑No �r <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _ <br /> Depth to Water: le" tt tt' <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation,Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity PTremie ❑Other: Type of Method: <br /> ater ent 4 Ib Water Cement 94 lb <br /> allon Bas eall ons Bags <br /> Thi, est Thinnest Thickest Thinnest VBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 204 10 40 4 <br /> 12.5 25 5 25 50 5 <br /> is 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 5 l9f 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.s*cehd.com <br />