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,;,0-L,I;ticb, SAN JOQUIN 4 A Environmental Health Department v v' ig COUNTY Greatness grows here. Monitoring Well/Soil Boring Inspection Report Date: 3 Z9 ZoL3 Inspector: IiASC-60l CONSTRUCTION Facility Address: 2JI L): ��`�� £;f1'4e+ Well Address: Total Depth: WP# C10 4V,?Jo Well#LT4 4.* S4 `2 Drilling Rig Type: Soil Boring#: Drilling Company: _'�'�=� Min 2" Annular EHD Seal Verified: El Yes ❑No Driller Onsite: i�'�f� Screen Length From: To: Consultant: Filter Pack From: To: Geologist: Bentonite From: To: Grout From: To: Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes ❑No casing If yes, location and distance: height SAMPLING ABOVE-GROUND Holding Temperature: ' COMPLETION COMPLETION Method: Ground Surtxs Screening Method: grout Verified Chain of Custody: ❑ Yes ❑No n• tt. tt. SPOILS Contamination Noted: ❑ Yes ❑No = '° If yes, spoils storage Location: t = C 2, l section ' — Covered: ❑ Yes ❑No �q0I — rravet pack If yes, material: Q _, GROUTING or DESTRUCTION Total Depth: —' Depth to Water: n• — ft• Grout Material: rU ee,,k Co-A44 MATERIALS/DEVELOPMENT Gallons of Grout Used: �5' Ztlu.c� 40 X_ 94110 Casing Type: []Well Installation 4ell Destruction Blank Feet Screen Feet ❑Boring Installation ❑Boring Destruction Slot Size: Bags of Cement: METHOD USED Bags Sand/Gravel: ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: &qmie Filter Pack Type/Size: Gravity ❑Other: Type of Method: G9 Water Cement 471b Water Cement 941b allons Bags lRallons Bags Thickest Thinnest tt Bags Thickest Thinnest Bags Bentonite/Cement Mix 3% MIX a% MIX 2.5 5 10 1 Bentonite per 47 Ib 1.41 2.47 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 7.5 15 3 15 1 30 3 10 20 4 20 40 4 12.5 25 5 25 50 5 15 30 6 30 60 6 17.5 35 7 35 70 7 20 40 8 40 80 8 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 www.sucehd.com