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�. • ,�oPGUlp p� <br /> SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness Gtngrows here. <br /> c^-q�'fpP�P7 <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: J L-5l a-2D Inspector: Sw 'y kl CONSTRUCTION <br /> Facility Address: �.�1.5 LWeV -Sc.GI/trPe_VVtUJ Lukil <br /> Well Address: Total Depth: <br /> WP# 009 Z qWell#: Drilling Rig Type: <br /> Soil Boring#: ,+ Min 2"Annular EHD Seal Verified: 11 Yes ❑No <br /> Drilling Company: Le tEk (�t/•D5 j e I�`nf <br /> Driller Onsite: l P 1A G V-0j,5 Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: WT height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COt"FLETION COMPLEnON <br /> Method: Ground Su lake <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No <br /> tt. <br /> tt. <br /> SPOILS <br /> — a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: <br /> slotted <br /> Covered: ElYes ❑Noy <br /> If yes, material: Pack <br /> GROUTING or DESTRUCTION Total Depth: d t , <br /> Depth to Water: S <br /> Grout Material: B e ,,v tUM e- «j rj <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 ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> t�KGravity ❑Tremie ❑Other: Type of Method: <br /> .k kev\ <br /> Water Cement 47 lb Water Cement 941b <br /> allons Bas RaI111 ons Bas <br /> Thickest Thinnest xBags Thickest Thiruiest OBags Benton Inn O to/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 <br /> 12.5 25 5 25 50 5 �/���s� I dUh ��� ti 2cJ �r(n/� e;ter <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 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />