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SAN JOAQUIN <br /> Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: I I VA Inspector: CONSTRUCTION <br /> Facility Address: ' OC) <br /> Well Address: Total Depth: 415 to <br /> WP# IA02I(,3 Well#: Drilling Rig Type: 6 <br /> Soil Boring#: GW.0 1 Min 2"Annular EHD Seal Verified: ® Yes ❑No <br /> Drilling Company: Pe,4ec0✓e DrLlltvw t , <br /> Consultant: <br /> Driller Onsite: Screen Length From: To: 3 5 <br /> Filter Pack From: T5 To: 3 <br /> «ysr,lg - <br /> Geologist: ALe4h �Bentonite From: � �1 To: -L - <br /> Grout From: TO: G <br /> y+�` S1' <br /> Public Water System Onsite: ❑ Yes ❑ 1,.aNtrlrw $u. 0 <br /> No COMPLETION ElStove Pipe §aChristie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes,location and distance: f height <br /> SAMPLING ABOVE-GROUND <br /> COWLETION CY-90X <br /> Holding Temperature: cohtalOMPLEl'ioN <br /> Method: Grounds s"i"' 7 <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑Noft• <br /> ft. <br /> SPOILS — <br /> _ a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: abnod �. <br /> sacdon _ S <br /> Covered: ❑ Yes ❑No — <br /> Brava pack <br /> If yes,material: ] c <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: ti LA- ft. — ft. <br /> Grout Material: 14 Pal- C_c►vf P14� <br /> Gallons of Grout Used: 394 ct t MATERIALS/DEVELOPMENT <br /> � Casing Type: PVC, <br /> L,/ell Installation ❑Well Destruction Blank 35 , Feet Screen_Feet <br /> `` <br /> ❑Boring Installation ❑Boring Destruction Slot Size: . &I G <br /> Bags of Cement: 5.$ Ip w <br /> METHOD USED Bags Sand/Gravel: l u W 1 Loc t <br /> Type/Brand of Bentonite: Lout, c i tti.rr 1. CL1O <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags allons Ba <br /> E <br /> Thinnest #Bags Thickest Thinnest kBaBs BentonitelCement Mix 3% MIX 5%MIX 5 1 5 10 1 Bentonite per47lb 1.41 2A7 <br /> 10 2 10 20 2 Bentonite per 94lb 2.82 4.7 <br /> 15 3 is 30 3 i20 4 20 40 4 <br /> 25 5 25 s0 5 <br /> 30 6 30 60 6 <br /> 35 3540 8 40 80 8 <br /> 5.51Or..5 utpr-A 10/16/2017 <br /> 11868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />