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fj''°c SAN-IOAQUIN <br /> ° couNTY Environmental Health Department <br /> Greatness grows here. <br /> MonitoringWell/Soil Boring Inspection Report <br /> Datel) Inspector: o,. A, CONSTRUCTION <br /> Facility ddress: -700 kz K'C. <br /> Well Address: Total Depth: <br /> WP# 00 4 11 .5 5L Well#: Drilling Rig Type: <br /> Soil Boring#: I <br /> Drilling Company: e o �/ � ►�+ `U h(� Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: uZ J Screen Length From: To: <br /> Consultant: A h4 kv YtVif-ovt-n Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING AWVE-GRCUNo <br /> Holding Temperature: COMPLETION COMPLEMN <br /> Method: Grand Surface <br /> Screening Method: RZ grout <br /> Verified Chain of Custody: ❑ Yes El No <br /> n. <br /> n. <br /> SPOILS = <br /> — e <br /> Contamination Noted: ❑ Yes 11 No — r <br /> If yes, spoils storage Location: .toned <br /> soc�on <br /> Covered: ❑ Yes ❑No = gi,ve'Pack <br /> If yes, material: u (' <br /> GROUTING or DESTRUCTION Total Depth: l 'T 4 IF <br /> GroutDepth to Water: n- n' <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: OO <br /> Casing Type: <br /> ❑Well Installation *ell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED I,` yBags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> Ll Pressure Grout Tf— Drill Filter Pack Type/Size: <br /> ❑ Gravity XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 41b <br /> allons Bas gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest 4Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 1 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 so 5 <br /> 15 30 6 30 1 60 6 <br /> 17.5 35 7 35 1 70 7 <br /> 20 40 8 40 1 80 8 <br /> 4q l aP 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 />