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c . SAN,,JOAQUIN <br /> Environmental Health Department <br /> .)'a1j.. i;;A. —COU NTY— <br /> s° l G1'P.ofnP.55 grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 111343 inspector: v�/�-J c� G"p` 1� CONSTRUCTION <br /> Facility Address: 6 S13 u-v C A V it � J !`71 <br /> Well Address: h Total Depth: <br /> WP# 0C)9q pq- Well#: '(S11jt), G Drilling Rig Type: <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Greo�' <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: � C,ty� <br /> 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 /> SAMPLINGsov=Gpouta❑ <br /> COWPLETION C.CWFL oX <br /> Holding Temperature: >ioha>�n.rioN <br /> Method: G odr)d 5wiacs T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El 7 IL <br /> No <br /> tr. <br /> SPOILS <br /> r o <br /> Contamination Noted: ❑Yes El No a <br /> If yes, spoils storage Location: <br /> stoned = G <br /> ussven = $ <br /> Covered: ❑ Yes ❑No . <br /> ;k 9- POCK <br /> If yes, material: _ <br /> 4 <br /> GROUTING-or-DESTRUCTION- Total Depth:l - T . , <br /> Depth to Water: '-/.S ' <br /> Grout Material: ds-t- C-ell'2 <br /> Gallons of Grout Used: Is, S, /G i Ol S MATERIALS/DEVELOPMENT <br /> < Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation6oring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity U'Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gall s Bags Raillons Ba s <br /> Thickest Thinnest It Bags Thickest Thinnest ttBags sar',toniteli eme-at Mix 3% Mix 50/. Mi <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 I I r t i <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 1 F 209 464-0138.1 www.s'cehd.com <br />