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SAN J OAQ U I N Environmental Health Department <br /> COUNTY- -- <br /> q�i � Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: jc <br /> Inspect : W1 c� 4 CONSTRUCTION rj 2-Facility Address: �✓IZ, ` U - 'Z 5 f 1 <br /> Well Adckess: Total Depth: 7 S— SJ Ma v`�(A- V <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: -Z ' < q Min 2"Annular EHD Seal Verified: ❑ Yes EJ No <br /> Drilling Company: , <br /> Screen Length From: To: <br /> Driller Onsite: 1/1 <br /> Consultant: Q Filter Pack From: To: <br /> � <br /> Bentonite From: To: <br /> Geologist: S V" <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes L1 No casing <br /> If yes, location and distance: W- T <br /> height <br /> SAMPLING ABovE.cRouNo <br /> Holding Temperature: CONFLETION COMPLEnoN <br /> Method: Ground Surf=* <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -�—n' <br /> n. <br /> it. <br /> SPOILS 4 <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: I sbttoa ` _ B <br /> a�cJon :'' — <br /> Covered: ❑ Yes ❑No,6), 5o <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: 1 F I n' <br /> Grout Material: 6?V <br /> Gallons of Grout Used: v MATERIALS/DEVELOPMENT <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 /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> fQ� Filter Pack Type/Size: <br /> 4GravityType of Method:�Tremie ❑Other: <br /> Water 7Ba <br /> 1 Water Cement 941b <br /> allons allons Ba s <br /> Thickest Thinnest Thickest Thinnest aBags 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 1 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />