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SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness groves here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: r1� /�,e1 Inspector: �'►•� CONSTRUCTION <br /> Facility Address: 10G0 5Lrvvtc to N <br /> Well Address: Total Depth: SG' <br /> WP# ZAft J6� Well#: fur-LI Drilling Rig Type: G " <br /> Soil Boring#: �i <br /> Drilling Company: ?n_4 a to✓e DWr tinny Min 2"Annular EHD Seal Verified: 7 Yes ONO <br /> Driller Onsite: Tn✓y a Screen Length From: 4161 To: 36 ' <br /> Consultant: <br /> Filter Pack From: of t To: 36 ' <br /> 0 u✓SG....S , <br /> Geologist: A LCA ,, entonite From: •3 V To: 3 I <br /> ' Grout From: 3 1' To: 01 <br /> Public Water System Onsite: El Yes El No COMPLETION S ElStovePipe Christie Box <br /> Domestic Well Onsite: ❑ Yes ONO casing <br /> If yes, location and distance: � height <br /> SAMPLING ABOVE-GROUND <br /> COWLETION C •BO <br /> Holding Temperature: cOMPLEon4rienoN <br /> Method: Grounds ^"' 7_ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No e• <br /> e. <br /> SPOILS <br /> O <br /> Contamination Noted: ❑ Yes ❑No ° <br /> If yes,spoils storage Location: abtt.d fi;' <br /> ►4c7an � _ S <br /> Covered: ❑ Yes ONO <br /> gravel Pack <br /> If yes,material: ] e <br /> GROUTING or DESTRUCTION Total Depth: =_ <br /> Depth to Water: -3H A. ' ft. <br /> Grout Material: tnt-ad cewTP..0- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: C66L0ac, 5 u ye✓� � C <br /> �� Casing Type: <br /> •Nell Installation ❑Well Destruction Blank _A6 Feet Screen [ft Feet <br /> Slot Size: Gl0 <br /> ❑Boring Installation ❑Boring Destruction . <br /> Bags of Cement: 10 a <br /> METHOD USED Bags Sand/Gravel: bag 5 -4 1oa 6G1n i kt",j <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: 1 Cr wrrl sloe <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 4711a Water Cement 94lb <br /> stations Bags 2allons BaRs <br /> Thickest Thinnest 9Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 5% MIx <br /> 2.5 s 1 5 10 1 1 Bentonite per 47 lb 1 1.411 2.47 <br /> 5 10 2 10 20 2 1 Bentonite per 94lb 1 2.821 4.7 <br /> 7.5 15 3 15 30 3 <br /> 12.5 ss s 225 so s I IMvt IT sv lils+� fr. 9✓ea L"&%Acq <br /> is 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 0 40 B 40 BO B <br /> 41C,40 (Sue! 10/16/2017 <br /> "5 t4Sec t v <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />