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SAN JOAQUIN Environmental Health Department <br /> I ! ` —COUNTY— <br /> o�; r Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> ri <br /> Date: 1 y Jl Inspector: A/vb c.ti CONSTRUCTION <br /> Facility Address: 2-tV3 L7�f117 D✓L yv�i�iiar <br /> Well Address: Total Depth: <br /> WP# yc-;'37 /t (c Well#: Drilling Rig Type: LNIf 7 r <br /> Soil Boring#: �3>, j-, 3 Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: ' ld w <br /> Driller Onsite: ".14 <br /> /c Screen Length From: To: <br /> '4r—Consultant: tit//4.-e -1c 1"1 Filter Pack From: To: <br /> Geologist: -D.- <e jc 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 /> i <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMPLETION <br /> Method: t=nd Surtacv <br /> Screening Method: oroLA <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> n. <br /> SPOILS = <br /> a <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes,spoils storage Location: sbd <br /> sacdon < <br /> Covered: ❑ Yes ❑No = g-V'W I <br /> If yes, material: :x _= <br /> GROUTING or DESTRUCTION Total Depth: t _ <br /> IF <br /> Depth to Water: .7-i Uf tt• tt. <br /> Grout Material: Aj-&- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation [Boring Destruction Slot Size: <br /> 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 ATremie ❑Other: Type of Method: <br /> Ib Water Cement 941b <br /> allons Bas ---' Fallons Bags <br /> Thi innest ttBags Thickest Thinnest ttBags <br /> Bentonite/Cement Mix 3% Mix 3% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> IS 1 30 6 30 1 60 6 <br /> 17.5 35 7 35 1 70 7 <br /> 20 40 8 40 80 8 <br /> L7 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />