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SAN JOAQUIN Environmental Health Department <br /> — -COUNTY <br /> Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1 3�/Q Inspector: CONSTRUCTION <br /> 3�/ �✓�U� <br /> Facility Address: 2-143 Mn,'.� <br /> Well Address: Total Depth: <br /> WP# C70-Sq02-q Well#: Drilling Rig Type: '0 D+'Q?�7k-'k DSC) <br /> Soil Boring#: PSi00 1313, R 1S <br /> Drilling Company: Ttm�, co.--, �-K� Min 2 Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: —7eSsG Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: 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: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION CCOOMPLETICN <br /> Method: Ground Surf acs <br /> Screening Method: er«n <br /> Verified Chain of Custody: ❑ Yes El No �ft' <br /> ft. <br /> tt. <br /> SPOILS <br /> V _ m <br /> Contamination Noted: ❑ Yes ❑No <br /> C <br /> If yes, spoils storage Location: slo <br /> sac9cn <br /> Covered: ❑ Yes ❑No = I-vv+pack <br /> If yes, material: _= <br /> GROUTING or DESTRUCTION Total Depth: IF IF <br /> Depth to Water: Ak-3 G.*J n• n' <br /> Grout Material: Na.-L+ Le if <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation XBoring 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 ❑Tremie kOther: 'Fi"4e 4-LL- Type of Method: <br /> ateri nt 71b water Cement 941b <br /> gallon a19.5 28110 ns Bags <br /> Thickest Thinnest 0Bags Thickest Thinnest sBags 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 /> 30 20 4 20 40 4 <br /> 12.5 1 25 5 25 SO 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> (ob 11V 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />