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SAN J OAQ U I N Environmen__ , Health Department <br /> Q , <br /> ` COU NTY-- <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Ito/19 Inspector: 1vr - CONSTRUCTION <br /> Facility Address: 1(v7-7-) f-f--44-4 <br /> Well Address: JkM M,- Total Depth: Z7S <br /> WP# 49032,S&--I Wel#: WIZ- Drilling Rig Type: �T,^^C. <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> a, Screen Length From: 2� To: -"!7 <br /> Driller Onsite: ��n <br /> Consultant: (�.aS.�,,,�S�e, <br /> Filter Pack From:'irrW To: -Z-1 1 <br /> �M <br /> Bentonite From: To: <br /> Geologist: <br /> Grout From: To: 2."1 <br /> Public Water System Onsite: El Yes El No COMPLETION L�'Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING Agpyg.GROUND <br /> Holding Temperature: COhFtETIoN ccoot�tpPLEn�oH <br /> Method: GroundSuian T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No <br /> ft. <br /> ft. <br /> SPOILS <br /> a <br /> — o <br /> Contamination Noted: ❑ Yes 1:1 No ` <br /> If yes, spoils storage Location: s>ott�d <br /> sao�on "n — <br /> Covered: ❑ Yes El No _ = t-w+Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: _ =_ <br /> Depth to Water: n' <br /> IF <br /> Grout Material: <br /> Gallon of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> L"JWell 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 /> e Gravity remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest NBags Thickest Thinnest »Bags 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 /> Z5 15 3 15 30 3 <br /> 10 20 4 20 40 4 Q W <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.s'cehd.com <br />