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SAN JOAQUIN <br />COUNTY - <br />Greatness grows {sere <br />Environmental Health Department <br />Monitoring Well/ )oil Boring Inspection Report <br />Date: �. (; � �- Inspector: _ 4l f &t4 C' b L CONSTRUCTION <br />Facility A dress• e�,? l-17 (�LMtiW * G/ i3 lu,W <br />Well Address: <br />WP# �-1 Well#. <br />Soil Boring#: , (3t pit; ly , tj l <br />Drilling Company: �L� �)T t�(t) <br />Driller Onsite: C•b�y9 I+ br4r 44eL <br />Consultant: t'd a ' •j, <br />Geologist: tL <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 />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑Yes ❑No <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />From: To: <br />From: To. <br />From: To: <br />From: To. <br />❑ Stove Pipe ❑Christie Box <br />• � <br />ie► <br />pit <br />1 <br />� <br />j <br />� <br />tt. - <br />SPOILS �� — <br />Contamination Noted: 171 Yes El No <br />If yes, spoils storage Location: <br />aacton <br />— <br />Covered. El Yes 1:1 No = . <br />If yes, material,:k <br />- <br />------GROUTING-or-DESTRUCTION —Total -Depth: Z2 <br />Depth to Water: 7C5 t --T'- - - - - - -_ - <br />Grout Material: �') i�w� <br />Gallons of Grout Used: ^- f �, t��ze�� MATERIALS DEVELOPMENT <br />Casing Types <br />❑Well Installation ❑Well Destruction <br />']Boring <br />Installation,�oring Destruction <br />METHOD USED <br />Li Pressure <br />❑ Gravity <br />Grout ❑Over Drill <br />emie <br />� <br />❑Other: <br />Water Cement 471b Water Cement 941b <br />allons <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 />Feet <br />BentonitelCement Mix <br />Bags <br />5°!° Mix <br />allons <br />Ba s <br />Thickest <br />Thinnest <br />1t Bags <br />2.82 <br />Thickest <br />Thinnest <br />ttBags <br />2.5 <br />5 <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 />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 />Feet <br />BentonitelCement Mix <br />3°�° Mix <br />5°!° Mix <br />Bentonite per 47 Ib <br />1.41 <br />2.47 <br />Bentonite <br />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 />