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SAN JOAQUIN <br /> COUNTY— <br /> Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: "3-1!>;bInspector: 149-es— CONSTRUCTION <br /> Facility Address: <br /> Well Address:/Aw7 S• _ /� Total Depth: <br /> WP#eyjz6 y Well#: Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: Screen Length From: To: <br /> Driller Onsite: p <br /> Consultant: Filter Pack From: To: <br /> Geologist: 11-4- <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING Asove-GaouNo <br /> Holding Temperature: COWLETION COMPLEMN <br /> Method: Grand Surface <br /> Screening Method: groan <br /> Verified Chain of Custody: ❑ Yes El No Ir —n' <br /> n. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes,spoils storage Location: stonae <br /> Covered: ❑ Yes ❑No <br /> If yes, material: r <br /> GROUTING or DESTRUCTION Total Depth: 3/ ;. <br /> Depth to Water:_PZ ft. <br /> Grout Material:- -1L 7C <br /> Gallons of Grout Used: 7711•,f jfijAi.+f MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> RKVell Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED �f�10Bags Sand/Gravel: <br /> ,,L 7.6 Type/Brand of Bentonite: <br /> ❑Pressure Grout []Over Drill Jam( <br /> 'W3. <br /> . Filter Pack Type/Size: <br /> El Gravity L'7Tremie ❑Other: UU ' Type of Method: <br /> .o.Tpe F Sb l Lr <br /> e 6e� water Cement 941b <br /> alio allons Bags <br /> Thic est Thinnest uBags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% MIX 3% 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 7-j/ �ry S� �� *",C:! <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 40 80 1 9 <br /> 70lL',-so' 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.secehd.com <br />