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SAN JOAQUIN Environmental Health Department <br /> .yrs► 1" —COUNTY— <br /> � r✓ Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: R_lS�l� Ins ector: !I CONSTRUCTION 22 rJ �t-fur <br /> \ <br /> Facility Address: RS0 701% N / C5l6 6,M <br /> Well Address: Total Depth: (0 _, ) 16 <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ElYes ❑No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Filter Pack From: To: <br /> Consultant: <br /> Geologist: (�IGWIAe,Qi <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: height <br /> SAMPLING Asove-GRouNo <br /> Holding Temperature: COWPLET10ht <br /> N CoPLEMN <br /> Method: Ground Sumacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes E]No �ft' <br /> ft. <br /> ft. <br /> SPOILS <br /> 0 <br /> Contamination Noted: ❑ Yes ❑No 2 bori np-25 =` <br /> i — o <br /> If yes, spoils storage Location: JA <br /> l�S �S alattad = <br /> on <br /> Covered: ElYes ❑No5 <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth:,D/'251 . <br /> Depth to Water: n• fc. <br /> Grout Material:Uafi 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 Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> Gravity Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> 'all <br /> a allons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest uBags Bentonilte/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 /> 70-f&G yL/ bays -�- l3 2 1 at " K/a--- 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />