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'P cOr <br />^�, z SAN JOAQUIN Environmental Health Department <br />"At`I —COU N T Y— <br />`ccP Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date:y/ 3/202 nnspector: SU - <br />Facility Address: 170/ S r?,►^eLk Al^� <br />Well Address: <br />WP# ( 1 /D 2 8 Well#: <br />Soil Boring#: BI <br />Drilling Company: CV-) <br />Driller Onsite: <br />Consultant: 65 h!i-"ua <br />Geologist: Stiiy�011_ <br />CONSTRUCTION <br />Total Depth: 15� <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes []No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br />Domestic Well Onsite: ❑ Yes ❑No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes ❑No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />i <br />GROUTING or DESTRUCTION Total Depth: /S <br />Depth to Water:_ , 601s) <br />Grout Material: Np f rr1&KL -r <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation XBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity VTremie ❑Other: <br />Water <br />allons <br />Cem 4nt 411 b <br />Bas <br />Water <br />gall ons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />ttBags <br />Thickest Thinnest <br />ttBags <br />2.5 <br />5 <br />1 <br />5 10 <br />1 <br />5 <br />10 <br />2 <br />10 20 <br />2 <br />7.5 <br />1s 30 <br />3 <br />10 <br />4 <br />20 40 <br />4 <br />12.5 <br />25 <br />5 <br />25 50 <br />5 <br />15 <br />30 <br />6 <br />30 60 <br />6 <br />17.5 <br />35 <br />7 <br />35 70 <br />7 <br />20 <br />40 <br />8 <br />40 80 <br />8 <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: _ <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />