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'Qu tv <br /> _�° -c° SAN�JOAQUIN <br /> y, �) _ Environmental Health Department <br /> COUNTY-- <br /> c�krP Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �2 2Z Inspector: i CONSTRUCTION <br /> Facility Address: 14 N q Z;W 2 Le4yA ,- <br /> Well Address: Total Depth: 1 1- 2 S ,I <br /> WP#n0 y 5 3� Well#: Drillin Ri T pe: 1,;KC 1 P Lz- rI <br /> Soil F 14 <br /> Boring#: 1 -<ALI ✓ -1 Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: o 2 't <br /> Driller Onsite: Screen Length From: To: <br /> tit G,e Filter Pack From: To: a-►d <br /> Consultant: µ <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 L1 No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMPTM_LEnoN <br /> Method: G=nd Suriacs <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No �tt• <br /> tt. <br /> tt. <br /> SPOILS Sgl-S94 <br /> Contamination Noted: ❑ Yes El No Ve 1 ; S <br /> If yes, spoils storage Location: stonad <br /> Covered: 11 Yes ❑Nov a sac^on <br /> g-vw pack <br /> If yes, material: �+ <br /> GROUTING or DESTRUCTION Total Depth:��l - — <br /> Depth to Water: t 0 tt tt' <br /> Grout Material: �- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used 2 0­ <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Baring InstallationXBoring 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 /> ❑ Gravity XTremie ❑Other: Type of Method: <br /> Water Ceme471b Water Cement 94 lb <br /> allons Bas allons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest "Bags 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 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> A.. �U �al /1 •C �� C 10/16/2017 <br /> 18681 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />