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SAN JOAQUIN <br />fNl -COUNTY Environmental Health Department <br />N�'q Qa'' Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: -Y- 2? -L/ Inspector: A/L4s&c: K <br />Facility Address: 5960 PFc. Sewe N►,' zen Qir <br />Well Address: <br />WP# cowgs8 Well#: <br />Soil Boring#: J) G� P7, D 8 <br />Drilling Company: /-f :ll s,•de (5;.ed&CA^scred <br />Driller Onsite: To," j A 7-6kv% <br />Consultant: tit,, ! pncf44t En,�:n•aenN� <br />Geologist: L'�O�le �— <br />Public Water System Onsite: ❑Yes ❑No <br />Domestic Well Onsite: ❑ Yes ❑No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes El No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: tV_ 1• Ibr_I6' <br />Depth to WaLer Nb kft &� <br />Grout Material: A14a,+ eonv&wk.. <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />y Ifs <br />❑Boring Installation CYBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />5°!° Mix <br />Water <br />allons <br />Cement 941b <br />Ba s <br />Thickest <br />Thinnest <br />#Bags <br />4.7 <br />Thickest <br />Thinnest <br />#Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7,5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />8o <br />8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />From: <br />From: <br />From: <br />From: <br />❑ Stove Pipe <br />❑Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />nelgnE <br />i� ;1 <br />\v <br />:. <br />comPLEnON <br />Ground Surf=* <br />grout <br />`s>v <br />tt. <br />gra <br />3°!° Mix <br />5°!° Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />_ <br />2.82 <br />4.7 <br />slotted <br />= <br />soc�on <br />x= <br />.. <br />✓� <br />tt. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />O <br />r <br />0 <br />Blank Feet Screen <br />Slot Size: <br />Bags of Cement: _ <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />tt. <br />Feet <br />Bentonite/Cement Mix <br />3°!° Mix <br />5°!° Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />Bentonite per 94 Ib <br />2.82 <br />4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.sicehd.com <br />