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SAN JOAQUIN Environmen,.al Health Department <br /> COUNTY— <br /> Greatness grows here. <br /> p Monitoring Well/Soil Boring Inspection Report <br /> Date:t� Z� Inspector:__M CONSTR CTIO ='O'Facility Address: 308 � �. "(/'Q Cv a <br /> Well Address: I De the <br /> WP# I-1j S Well#: — 9 �{ Drilling Rig Type: <br /> Soil Boring#: �j(9 Min 2"Annular EHD Seal Verified: ❑Yes []No <br /> Drilling Company: �j Driller Onsite: 4 gA Screen Length From: To: <br /> �1��T `t Filter Pack From: To: <br /> Consultant: <br /> Geologist: i Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No P Old casing <br /> If yes, location and distance: 11height <br /> dt✓$�'o�td <br /> SAMPLING Sil ABOVE3ACUND T <br /> CciNPLErioN COMPLETION <br /> Holding Temperature: 5r1�� CCt.+rlerioN <br /> Method: C-1 ck rod S"i"' 7- <br /> Screening Method: orout <br /> Verified Chain of Custody: ❑ Yes ❑No 1t _ -`— h. <br /> SPOILS v <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: #ianad ,i = <br /> a#e0on <br /> Covered: ❑ Yes ❑Nopack <br /> = �� <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth;/ _ <br /> Depth to Water: n• _ �tL�' <br /> Grout Material: � o S/DEVELO <br /> MATERIALPMENT <br /> Gallons of Grout Used: f <br /> Casing Type: <br /> y� II Ins allatign I�Well Destruc ion Blank Feet Screen Feet <br /> S !'j�IJI�/3$ S(al (1�8/ 54%IA Slot Size: <br /> ❑Boring Installation ❑Boring De t uction k�q �� gags of Cement: <br /> METHOD USED St, d; Bags Sand/Gravel: <br /> 5 5(a <br /> ❑Pressure Grout C6ver Drill Type/Brand of Bentonite: <br /> A Filter Pack Type/Size: <br /> L SG IY Type of Method: <br /> Gravity ❑Tremie ❑Other: yp <br /> Water Cement 471b Water Cement 941b <br /> allons Bags stations Ba s <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 5%MIX_ <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 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 s0 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 1 40 BO B <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br />