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SAN J OAQ U I N Environment; lealth Department <br /> —COUNTY— <br /> Greatness gravis here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Co-"f-11 Inspector: NAS tee— CONSTRUCTION <br /> Facility Address: I�PZy Ar rye j Ct <br /> Well Address: Total Depth: <br /> WP#Vy 3g(o7/ Well#: Drilling Rig Type: <br /> Soil Boring#: S8/,2 ,3, y Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company:?•Ke.c.a�L <br /> Driller Onsite: /'^ Screen Length From: To: <br /> Consultant: A6e0'--��1''�� Filter Pack g From: To: <br /> Geologist: IV,'/if�k,' <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> iii <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMPLETioN <br /> Method: C-=ndStaiacs T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No ft' <br /> ft. <br /> tt. <br /> SPOILS : <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: slotted _ <br /> s.&cdon r _ <br /> Covered: ❑ Yes ❑No = r,-vw Pack <br /> If yes, material: ' <br /> GROUTING or DESTRUCTION Total Depth: 9 y1 <br /> Depth to Water: eZ' n' <br /> Grout Material: deoW rerrt n MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:'S-1, �17� `_3��_ Casing Type: <br /> []Well Installation ❑Well 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 ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas eallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest 4Bags 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 /> 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 />