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" <br /> ' S='IN`° � SAN_JOAQUIN Environment, )Health Department <br /> —COUNTY- <br /> 1 <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: CONSTRUCTION <br /> O �`��`W-Lp Inspector: <br /> Facility Address:_to�K�LP � ,aol�pTotalDepth: <br /> Well Address:\y+VJ-� e' &��WP# Well#: MW- Fo Drilling Rig Type: <br /> Soil Boring#: N\'�' Min 2" Annular EHD Seal Verified: ❑ Yes ONO <br /> Drilling Company: �*!St*do'kr Screen Length From: To: <br /> Driller Onsite: nN& sD - Filter Pack From: To: <br /> Consultant: O<C\ , t" V-kt' Bentonite From: To: <br /> Geologist: 'C 0'A� S Grout From: To: <br /> Public Water System Onsite: ❑ Yes 1$Qo COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: El Yes No casing <br /> _ height <br /> If yes, location and distance: <br /> SAMPLING ABOVEGROUND CHRM-Y-BOX <br /> COMPLETION COWLE110N <br /> Holding Temperature: 0radnd Sara¢* -z—�-^ <br /> Method: orwt <br /> Screening Method: —_ft• <br /> Verified Chain of Custody: ❑ Yes ❑No n• <br /> SPOILS NW� e <br /> r — <br /> Contamination Noted: ❑ Yes ❑No o <br /> If yes, spoils storage Location: t1o11°d "A = 8 <br /> t�c5on 3i <br /> Covered: ❑ Yes ❑No ; = w+vot POCR <br /> If yes, material: v,c <br /> GROUTING or DESTRUCTION Total Depth:.__ <br /> Depth to Water: `i 3 <br /> Grout Material: lVt (p�\� t MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Casing Type: <br /> Blank Feet Screen Feet <br /> ❑Well Installation [Well Destruction Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> Iff <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> C�Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> Type of Method: <br /> ❑ Gravity ikTremie ❑Other: <br /> Water Cement471b Water cement 941b <br /> allons Ba s aiions Be s <br /> Thickest Thinnest aaags _ BentonitelCement Mix 3% Mix 5% Mix <br /> Thickest Thinnest geags Bentonite per 47lb 1.41 2.47 <br /> z5 5 10 1 5 2 lB 20 2 Bentonite per 94 Ib 2.82 4.1 <br /> 7.5 15 <br /> 3 15 30 3 <br /> 10 <br /> 30 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 /> Y0 40 B 40 eB B 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 WwW sicehd corn <br />