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SAN JOAQUIN <br /> r _ Environmental Health Department COUNTY—Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: II w Inspector: 0'-/i CONSTRUCTION <br /> Facility Address: 0 2/t V-- <br /> Well Address: Total Depth: �� <br /> WP# ���� Well#: Drilling Rig Type: CPT �- 7 S p��o�vne <br /> Soil Boring#: 3— 2 <br /> Drilling Company: 6r Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: &(il <br /> Filter Pack From: To: <br /> Geologist: A I Vi n. 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 ABOVE-GROUND <br /> Holding Temperature: COWLF-TION cco _own.EnoN <br /> Method: G=nd Surtwe <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No M <br /> tt. <br /> SPOILS I= I <br /> n. <br /> =_ <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: slatted ' <br /> s = <br /> n <br /> Covered: ❑ Yes ❑No��D93 <br /> pnwl Pads <br /> If yes, material: (� <br /> GROUTING or DESTRUCTION Total Depth: �q0 <br /> Depth to Water: <br /> Grout Material: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: OY1S Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring InstallationBoring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity MTremie ❑Other: Type of Method: <br /> Water Cement 1bWater Cement 941b <br /> allons Billons Bags <br /> Thickest Thinnest uBags Thickest Thinnest uBags 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 8 <br /> q04' q"s /„ten S 10/16/2017 <br /> `18_[68 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />