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SAN JOAQUIN Environmental Health Department <br /> COUNTY— <br /> ,,,,, Gre°tness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 3 2 Inspector: faVo66 CONSTRUCTION <br /> Facility Address: 639 1Aj C.ILllh�)>♦ 5w4or1 <br /> Well Address: Total Depth: <br /> WP# 2.40014S Well#: Drilling Rig Type: <br /> Soil Boring#: tkW -7DU 2,1 V A yA W 5 Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: <br /> Drilling Company: 1�P(© Q- Screen Length From: To: <br /> Consultant: i )&xA'y1\W -ten Filter Pack From: To: <br /> Geologist: iV1�Qd P 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: n height <br /> SAMPLING ~Bowe-GROUND CHRMTY-BOX <br /> Holding Temperature: COMPLEMN COMPLETION <br /> Method: Ground Svrae�—r--- <br /> Screening Method: ofrOW <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑Yes ❑NoP =_ ~ <br /> e <br /> If yes,spoils storage Location: 4lonad t <br /> Covered: ❑Yes ❑No <br /> :1 gravot POCK <br /> If yes, material: <br /> 1,t <br /> GROUTING or DESTRUCTION Total Depth: 0 1 DI <br /> Depth to Water: h n' <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> .. I^'''' Casing Type: <br /> ❑Well Installation Well Destruction e"CN Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity Y4remie Zother: C12 r�Uh►� Type of Method: <br /> Water cement 471b Water Cement 941b <br /> allons Bags Rallons BaRs <br /> Thickest Thinnest pBags fild:ezt Thinnest #Bags BentonitelCeroent 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 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 1 <br /> 20 40 8i 40 i 80 0 <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 />