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SAN JOAQUIN Environmental Health Department <br /> —COU NTY— <br /> <rc <br /> =. �;rvatness grows fere <br /> Monitoring Well/Soil Boring Inspection Report <br /> q / i-` <br /> Date: ✓ 22( 2I Inspector: `} 3 6K4i CONSTRUCTION <br /> Facility Address: Oo C L-,vVCk. )-t -, <br /> Well Add e s,:: {� Total Depth: <br /> c <br /> WP# l Well#: M p I� Drilling Rig Type: <br /> Soil Boring#: <br /> y� <br /> Min 2"Annular EHD Seal Verified: 1:1 Yes 11 No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: or, Filter Pack From: To: <br /> Geologist: �J C_ �- KC <br /> 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 El No casing <br /> If yes, location and distance: 37 height <br /> SAMPLING AMIVE-GROUND <br /> Holding Temperature: COWPLETION ccmP�LfinooN <br /> Method: G=nd Sudace '+ <br /> Screening Method: Qrout <br /> Verified Chain of Custody: ❑ Yes El No �ft. <br /> it. <br /> ft. <br /> SPOILS _ <br /> m <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: sattad <br /> aaction x. <br /> Covered: l s El No _ Q-Vlw P-*If yes, material: S I e e( P(L Y) <br /> GROUTING or DESTRUCTION Total Depth: 3 O <br /> C)/ <br /> Depth to Water: _3r> n- n' <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ^'Z Tc to <br /> Casing Type: <br /> ❑Well Installation ell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction 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 wremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons BaRs <br /> Thickest Thinnest kBags Thickest Thinnest ttBags Bentonite/Cement Mix 30/. Mix 55%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 I www.sacehd.com <br />