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r <br /> • 'Opn,.U�1v CO,.. <br /> �= z SAN_J OAQ U I N Environmental Health Department <br /> COUNTY­- <br /> Greatness <br /> OUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: -zM--Z C Inspector: A4r'VA,4-'9 CONSTRUCTION <br /> Facility Address: <br /> Well Address: !�e g�� cz,, lc� /�.P Total Depth: <br /> WP# ee? z/G 'k-5- Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: 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 Y casing <br /> If yes, location and distance: I height <br /> SAMPLING AWVE GROUNo <br /> Holding Temperature: COMPLETION CCCMPLE'nCN <br /> Method: around Sumacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> ft. <br /> SPOILS . <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: abed _ B <br /> sscJon <br /> Covered: ❑ Yes El No _ gravel Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: /4P n• n' <br /> +.�etrt'R7late ria l: <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> �� Casing Type: <br /> ❑Well Installation C3/Vell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction <br /> 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 ❑Tremie CTOther: ti%-&'1 s41-ec — Type of Method: <br /> ^-Vj& <br /> Water Cement 471b Water Cement 941b <br /> gall s Bas gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest tlBags Bentonite/Cement Mix 3% Mix 3% 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 �r s <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 � S.zj f/,jf <br /> r/ 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />