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SAW, JOAOUIN <br />--COUNTY- -- <br />Greatness <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Inspector: <br />Facility Address: 4KS f Ar" <br />Well Address: <br />WP#60(/Z�pgy Well#: <br />Soil Boring#: fid/ -eV ,Zi(i <br />Drilling Company: AAK./- Lan6/- %w - <br />Driller Onsite: TJ"Nhy <br />Consultant: Eh qv <br />Geologist: e!5 y <br />Public Water System Onsite <br />Domestic Well Onsite <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />Verified Chain of Custody: ❑ Yes El No <br />CPr)lI C <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 />rnnnal FTinti <br />Contamination Noted: ❑ Yes ❑No L ; /a, <br />If yes, spoils storage Location: L; 15/ <br />Covered: <br />If yes, material: <br />❑ Yes ❑ No ZOO <br />2.5I <br />GROUTING or DESTRUCTION Total Depth: /off LSA <br />Depth to Water: Na G J <br />Grout Material: 1Va4d eaor0Z <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation VBoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />LIG Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />rt Bags <br />2.s <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 />4 <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 />80 <br />8 <br />i0'c�s <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 />ft. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />ft. <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <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 />