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SAN JOAQUIN <br /> I� � _ Environmental Health Department <br /> — COUNTY <br /> �ci<<Foa•'j Greutness grows herr. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 0-167120P Inspector: CONSTRUCTION <br /> Facility Address:� 6- M(Ailn. Vii-. `j} Cj*r). <br /> Well Address: Total Depth: <br /> WP# �(��1 N rj Well#: Drilling Rig Type: <br /> Soil Boring#: 7A Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: V <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: U) �Cl,(A ��U1�1� Filter Pack From: To: <br /> Geologist: L 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: IT height <br /> 59 <br /> SAMPLING ABOVE-GROUNp CHR__ <br /> Holding Temperature: COMPLETION COMPLEnoN <br /> Method: -GroundSurface <br /> Screening Method: 02. <br /> grout <br /> Verified Chain of Custody: ❑ Yes El No �tt• <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: slotted <br /> soon <br /> Covered: ❑ Yes ❑No _ s <br /> ack <br /> If yes, material: 1 <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: G `1c� <br /> Grout Material:NP031 Ce(yV- 7_ <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Casing Type: <br /> ❑Well Installation ❑Well Destruction `kl; Blank Feet Screen Feet <br /> Slot Size: <br /> ❑ � <br /> Boring Installation Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> /9-Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas eallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest ttBags 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 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 T 209 468-3420 1 F 209 464-0138 1 www.sacehd.com <br />