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SANJOAQUIN <br />rianigr) --COUNTY <br />kir. <br />— <br />\ dS <br />Greatness grows heir <br />Environmental Health Department <br />ENo Public Water System Onsite: El Yes <br />E Yes ENo Verified Chain of Custody: <br />SPOILS <br />Monitoring Well/Soil <br />Date: -3) 12_1 Inspector: <br />Facility Address7 2.30 6 eo. ive 5.to <br />Well Address: <br />wiOO'flTQ <br />Soil Boring#: a_ <br />Drilling Company: Vx_51-- Co454- explorakton <br />Screen Length Driller Onsite: <br />Consultant: <br />Geologist: <br />Min 2" Annular EHD Seal Verified: El Yes <br />From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />Domestic Well Onsite: CI Yes ENo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Contamination Noted: 111 Yes El N o <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />(=I Yes III No <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: toC° V•AN)ic'eK- <br />Grout Material: erkk- Upoie* <br />01AA <br />EWell Installation El Well Destruction <br />CI Boring Installation .Boring Destruction <br />METHOD USED <br />EPressure Grout EOver Drill <br />S-Gravity ETremie E0ther: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94W <br />Bags <br />Thickest Thinnest 4Bags Thickest Thinnest 4Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 <br />7.5 15 3 15 30 3 <br />10 20 4 20 40 4 <br />12.5 25 5 25 SO 5 <br />15 30 6 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />COMPLETION 111 Stove Pipe El Christie Box <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />Ground Surface <br />lk <br />grout <br />ft <br /> ft <br />-ft <br />slotted <br />section <br />ft I---- <br />gravel pazic <br />ft <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <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 />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.corn <br />Well#: <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />CI E Cal ji c. <br />2-cwe,et 5iib4i .-n <br />ENo <br />Gallons of Grout Used: <br />6‘4