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S A N J O AQ U I N Environmental Health Department <br /> - --COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> N <br /> Date: 7� �/9 Inspector: CONSTRUCTION <br /> Facility Address: stir�, L', <br /> Well Address: Total Depth: <br /> WP# 3 Il Well#: Drilling Rig Type: <br /> Soil Boring#: r W-d p <br /> Drilling Company: jZZ'ni► cd-J-- >f�� Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: � Q� Screen Length From: To: <br /> Consultant: 4.,.Bd )Je GG Filter Pack From: To: <br /> Geologist: <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 /> —aw, <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: °Of"F�ION c�1EnoN <br /> Method: Ground Surf=* <br /> Screening Method: ar«n <br /> Verified Chain of Custody: ❑ Yes []No <br /> ft. <br /> ft. <br /> SPOILS = <br /> w _ o <br /> Contamination Noted: ❑ Yes El No = <br /> If yes, spoils storage Location: atoned <br /> on <br /> Covered: ❑ Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: . <br /> Depth to Water: /- n n <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity ATremie ❑Other: Type of Method: <br /> at Cement 471b Water Cement 941b <br /> gallon Bags gallons Bags <br /> Th Thinnest #Bags Thickest Thinnest ltBags 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 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 35 70 7 <br /> 20 40 8 40 80 8 <br /> ti 1-20 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 />