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SAN JOAQUIN Environmental Health Department <br /> - - - <br /> COUNTY <br /> - <br /> . �IIIP. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ': Inspector: CONSTRUCTION <br /> Facility Address: IL\t4 p C L01 w"56 1 <br /> Well Address: Total Depth: <br /> WP# l�5'2 D Well#: IM ITV- Drilling Rig Type: 7, <br /> Soil Boring#: <br /> I/w� "( ctrtL ldlk Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: LO'u <br /> Driller Onsite: Screen Length From: 'go To: 6 <br /> Consultant:_,,�j aw� J�^rV�T+/x ry, G . Filter Pack From:g_ To: <br /> Geologist: So•G f5iul)� Bentonite From: To: S <br /> Grout From: 516 To: 67 <br /> Public Water System Onsite: ❑Yes ONO COMPLETION ❑ Stove Pipe <br /> p Christie Box <br /> Domestic Well Onsite: ❑ Yes ONO casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND CAST,-BOX <br /> Holding Temperature: OONFLETION COMPLETION <br /> Method: onwna senao+ —F-- <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ONO <br /> n. <br /> SPOILS ky <br /> Contamination Noted: ❑Yes ❑No ,`` =_ • <br /> If yes,spoils storage Location: �lottae = s <br /> s°cdon = 3 <br /> Covered: ❑Yes ONO _ grav"Pack <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: % <br /> Grout Material: %V <br /> Gallons of Grout Used: 2 AD C4r WL -S MATERIALS DEVELOPMENT <br /> Casing Type:: 2 t'L L <br /> j Well Installation ❑Well Destruction Blank (a(7 Feet Screen Feet <br /> Slot Size: D,O 1 <br /> ❑Boring Installation ❑Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: t <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: ('V o thw e,.4tA <br /> Filter Pack Type/Size: <br /> ❑ Gravity FTremie ❑Other: Type of Method: <br /> Water Cement 47lb Water Cement 94lb <br /> allons Bags gallons Bags <br /> Thickest Thinnest peags Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 5% MIX <br /> 2.s 5 1 5 10 1 Bentonite per47lb 1.41 2.47 <br /> 10 2 10 20 2 Bentonite per 94 Ib 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 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 1 8 <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.socehd.com <br />