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SAN JOAQUIN Environmental Health Department <br /> —COUNTY - <br /> Greatness grows here. <br /> Monitoring Werllll/-Soil Boring Inspection Report <br /> Date: 1 /2 q Inspector: If CONSTRUCTION <br /> Facility Address: 1263 (e+ Cwr <br /> Well Address: Total Depth: <br /> WP# 010 200 Well#: Drilling Rig Type: <br /> Soil Boring#: fb 6 Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: <br /> Driller Onsite: C �5 'Tv�vi7 Screen Length From: To: <br /> Consultant: Kr a✓n a 5 Filter Pack From: To: <br /> Geologist: Z_ Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑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: COWLETION C00AP�tEnoN <br /> Method: Ground Surfaas '+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -,II, --n' <br /> it. <br /> ft. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: sloned <br /> sie9an E <br /> Covered: ❑ Yes El No <br /> If yes, material: 4 <br /> GROUTING or DESTRUCTION Total Depth: �7 t"� j __ <br /> Depth to Water: f-( n• n' <br /> Grout Material: <br /> Gallons of Grout Used: Cep, t0y�j MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> El Boring Installation XBoring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity TATremie ❑Other: Type of Method: <br /> Water Cemen 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest ttBags 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 i 8 <br /> ��log' 02 S bgp5 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 wvvw.s'cehd.com <br />