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SAN G`r=JOAQUIN <br />COUNTY <br />\T G;"eatness grows ,'sere. <br />Monitoring Well/ oil Boring Inspection Report <br />Date: �• .- Inspector: CONSTRUCTION IIt\ <br />Facility <br />Well Address: <br />WP # We <br />Soil Boring#: <br />Drilling Company:�%Q�'L,S`�v <br />Driller Onsite: <br />Consultant: NQ kA'*0 �4 <br />Geologist: <br />Public Water System Onsite: <br />Domestic We11 Onsite: <br />if yes, location and distance:, <br />SAMPLING �`'� <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: <br />SPOILS N\P <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />Total Depth: <br />4 <br />Iry ko Drilling Rig Type: <br />Yes ❑No <br />❑ Yes l]No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />GROUTING or DESTRUCTION Total Depth: �j <br />Depth to Water: <br />Grout Material. <br />Gallons of Grout <br />[]Well <br />Installation Well Destruction <br />:]Boring Installation El Boring <br />Destruction <br />METHOD USED <br />❑ Pressure Grout Xjuver Drill <br />;Z(G ❑Tremie ❑Other: <br />Yater <br />alions <br />cement 471b <br />Bas <br />�°�o II�JIii� <br />'NaterCement <br />allans <br />941b <br />Ba s <br />Thickest <br />Thinnest <br />#Bags <br />Thickest <br />Thinnest <br />#Bags <br />2.5 <br />5 <br />2082 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />1 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 />Min 2" Annular EHD Seal Verified. <br />Screen Length From: <br />Filter Pack From: <br />Bentonite <br />Grout <br />COMPLETION <br />•M1 <br />❑ Yes ❑No <br />To: <br />To: <br />From: To: <br />From: To: <br />❑ Stove Pipe ❑Christie Box <br />using <br />igiit <br />�&FLETjoN e =O.N <br />Grp nd sLaiaC2 <br />�2. <br />fl. <br />_ QrxV1w Pack <br />IF 1F <br />M. <br />MATERIALS/DEx <br />/ELOPMENT <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 <br />Feet <br />10/16/2017 <br />1868 E. Hazelton Avenue J Stockton, California 95205 (T 209 468-3420 J F 209 464-0138 J vvww.sjcehd.com <br />�entonitef�ement i�li� <br />�°�o II�JIii� <br />�°�0 1(�Iiix <br />Bentonite per �� Ib <br />1.�9 <br />2.�� <br />Bentonite per 94 Ib <br />2082 <br />4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue J Stockton, California 95205 (T 209 468-3420 J F 209 464-0138 J vvww.sjcehd.com <br />