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SAN JOAQUIN Environmental Health Department <br /> COUNTY--_ <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:I /29 ` `/( Inspector: A A0rL CONSTRUCTION <br /> Facility Address: S0� /�0� 0.6 <br /> Well Address: Total Depth: <br /> WP# 0039 05 4 Well#: Drilling Rig Type: <br /> Soil Boring#: 02- <br /> Min 2"Annular EHD Seal Verified: El Yes 11 No <br /> Drilling Company: V t W Ir I I n <br /> Driller Onsite: 0jqj Screen Length From: To: <br /> Consultant: e. Filter Pack From: To: <br /> Geologist: 114?5"I 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: COt"F�ION C4 <br /> -ETION <br /> Method: Gmnd Surta" <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No —`---n' <br /> ft. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No =` <br /> If yes, spoils storage Location: <br /> slotted _ 3 <br /> socion M <br /> Covered: ❑ Yes ❑No a =_ <br /> If yes, material: a <br /> n 5 _ .. <br /> GROUTING or DESTRUCTION Total Depth: 0� A- __ <br /> IF <br /> Depth to Water: X1 ' �f n- n' <br /> Grout Material: LOBI. Ck/Yvl"— <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation)Boring Destruction Bags iz Cement: <br /> METHOD USED /' �► _I ; e-�w Bags Sand/Gravel: <br /> b l� Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> X Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Ceme 471 Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest 71 Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% 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 /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.socehd.com <br />