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t11N�'. <br />c', <br />SAN4JOAQUIN <br />a Environmental Health Department <br />--COU NTY-- <br />�q,P' Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: l 10 122 Inspector: '�:>rxk i ACL S <br />Facility Address: °j <br />Well Address: <br />WP# 0c) 1-k!jR1q Well#: <br />Soil Boring#: 1 f; 1Z <br />Drilling Company' "ferracor\ <br />Driller Onsite: <br />Consultant: n <br />Geologist: _ A0r\ <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 />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />❑ Yes 11 No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: WPCs+ 0P"4A+ <br />Gallons of Grout Used: /I- KU90 <br />[]Well Installation []Well Destruction <br />❑Boring Installation IiWoring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />,&.Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />eallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />1 1 1 <br />5 <br />10 <br />1 <br />5 10 <br />2 1 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 25 <br />5 <br />25 <br />50 <br />5 <br />15 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 35 <br />7 <br />35 <br />70 <br />7 <br />20 40 <br />8 <br />40 <br />80 <br />8 <br />casing <br />height <br />ABOVE -GROUND C 1RISTY-80X <br />COMPLETION OOMPLETION <br />Gram Surface <br />grout <br />n. <br />n. <br />slotted <br />sec�on <br />_ = prawt Pack <br />y <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 />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.secehd.com <br />