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c <br /> SAN�JOAQUIN <br /> aj Environmental Health Department <br /> --COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: A&-ll CONSTRUCTION <br /> Facility Address: NZI /1 ecJ-j A%I <br /> Well Address: Total Depth: <br /> WP#d0410(o2 Well#:, Drilling Rig Type: <br /> Soil Boring#: /`SSA—��, 1-1 —Z�0. Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: jPt ?!gZ414 D.-, _ <br /> Driller Onsite: A&h Screen Length From: To: <br /> Consultant: rk� Filter Pack From: To: <br /> Geologist: A'O 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: height <br /> _V1 9 <br /> SAMPLING ABovE.CIRCUND <br /> Holding Temperature: COWLETION COMPLETION <br /> N <br /> Method: Gil Su w* <br /> Screening Method: gran <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> ft. <br /> n. <br /> SPOILS <br /> 1 <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: sbttQd <br /> aeon <br /> Covered: ❑ Yes ❑No ��/ � _ g-vW pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 261 3e t <br /> Depth to Water: a tt• — ft. <br /> Grout Material: Alewilu..o• <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> []Boring Installation [Koring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> ��, <br /> �� Filter Pack Type/Size: <br /> ❑ Gravity E?fremie ❑Other: Type of Method: <br /> WaterWater Cement 94 lb <br /> allons Bas gall ons Bags <br /> Thickest Thinnest uBags Thickest Thinnest 9Bags 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 �L�1 �� S�r�/s M��f l� �M ` 260 WO <br /> 12.5 25 5 25 50 5 <br /> IS 30 6 30 60 6 Zv SG $ <br /> 17.5 35 7 35 70 7 <br /> 20 40 s 1 40 80 a <br /> /3 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.s'cehd.com <br />