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SAN JOAQUIN <br /> Environmental Health Department <br /> COUNTY <br /> Grpntnes <br /> OUNTYGr.pntnes grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 3 2lD s Inspector: ft'Yi1VV�h,�,Jfq CONSTRUCTION <br /> Facility Address: _n-�-5 Mph rd /91/8,c!l1�Gh <br /> Well Address: Total Depth: <br /> WP# 1� S14 --Wel I#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: ,(S Min 2"Annular EHD Seal Verified: El Yes []No <br /> Driller Onsite: Q� ) Screen Length From: To: <br /> Consultant: Eox LOOMIT 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 ABOVE-GROUND <br /> Holding Temperature: COWLErt°N OMPON <br /> Method: GroindS"d"' <br /> Screening Method: grow <br /> Verified Chain of Custody: ❑ Yes El No ft• <br /> ft. <br /> tt. <br /> SPOILSr <br /> Contamination Noted: ❑ Yes El No —' <br /> If yes,spoils storage Location: stoned <br /> asc�on = <br /> Covered: ❑ Yes ❑No = grs,!,wP-* <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 110htd -steed a/��igrn 4 _ <br /> Depth to Water: �O 'a��--� — n• <br /> Grout Material: � MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: `� l <br /> Casing Type: <br /> E]Well Installation well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑ Slot Size: <br /> Boring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Pressure Grout ❑Over Drillwe1� Type/Brand of Bentonite: <br /> ()l 0�y Filter Pack Type/Size: <br /> ❑ Gravity 15remie ❑Other: � ( Type of Method: �1r <br /> Water Cement 471b Water Cement 941b —ILA i _ �I <br /> allons Bas allons Bas 1 V 1j I, <br /> — Z ', — i.S <br /> Thickest Thinnest »Bags Thickest Thinnest #Bags Bentonite/Cement MIX 3%Mix 5%MIX <br /> 2.5 s 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 15 30 3 <br /> 10 20 4 20 40 4 /� /� /� p <br /> 12.5 25 5 25 50 5 Y IUh� Of �'e ( -Ir PMCLt1 (iq "J4 <br /> 15 30 30 0 6 <br /> 17,5 35 7 7 35 70 7 �1� <br /> 20 1 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />