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SAN J OAQ U I N Environmental Health Department <br /> ----COU NTY- <br /> 9L,�oa�;F' Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: ' k Y'e f- CONSTRUCTION <br /> Facility Address: 2 2 S I/v t�/I�& a Cot- <br /> Well Address: Total Depth: <br /> WP# c2(? Well#: Drilling Rig Type: <br /> Soil Boring#: -00 _ l —0—OF Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: bec " <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: rA�U SSS Filter Pack From: To: <br /> Geologist: Mdi5� Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: IF7LT height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONFLEMN COMPLEnoN <br /> Method: Ground Surlacs <br /> Screening Method: gro'n <br /> Verified Chain of Custody: ❑ Yes El No �ft' <br /> ft. <br /> tt. <br /> SPOILS <br /> A � C <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: slotted _ B <br /> on <br /> Covered: El Yes 1:1 No = gi,*11 pack <br /> If yes, material: <br /> 00 <br /> GROUTING or DESTRUCTION Total Depth:30- t <br /> Depth to Water: 002--�No wall. 0-C 0 wa-V n• n' <br /> Grout Material: Nub t'tY m'I <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring InstaIlation'�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 �Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest 4Bags 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 /> 12.0 20 4 20 40 s ( I1 I j + 17Jat 4-yv.-, <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 8o 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.socehd.com <br />