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SAN JOAQUIN <br /> a Z, Environmental Health Department <br /> --COUNTY— <br /> Greutness grows Gere <br /> I Monitoring Well/Soil Boring Inspection Report <br /> Date: WL4*16 _Inspector: �(/�� CONSTRUCTION <br /> Facility Address: �(h r �n) bo iAAL MAmP 2,0/ <br /> Well Address: Total Depth: <br /> WP# 0D Lf I 0 Z 5 Well#: Drilling Rig Type: ��i NS-# <br /> Soil Boring#: 81- Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: A At A 994f <br /> Driller Onsite: 1 1 Screen Length From: To: <br /> Consultant: SECQ$�is Filter Pack From: To: <br /> Geologist: 32,br&jha2,4- Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: ITTLT height <br /> ffl- W— _QW—f <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CONFLEf1ON c�tFnoN <br /> Method: Ground Surface <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: .totted <br /> aeon — B <br /> Covered: ❑ Yes ❑No <br /> g-vw Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: . =_ <br /> Depth to Water: /3'"/y/ <br /> Grout Material: rjaJlC- �'i/�� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation Nboring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity 1�4remie ❑Other: Type of Method: <br /> Water ment 411Water Cement 941b <br /> allons eall ons Bags <br /> Thickest Thinnest BBags Thickest Thinnest bBags Bentonite/Cement Mix 3% Mix S% 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 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 />