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SAN 10AQUIN <br />'.=,, COUNTY---- <br />''r9<rp�aGreatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: �b l Inspector: ff✓}SL-z< <br />Facility Address: /V, IUrt I,.y; <br />Well Address: <br />WP# 0C) 3`dZ-() Well#: <br />Soil Boring#: 13z <br />Drilling Company: j!4111 -2c,, <br />Driller Onsite: <br />Consultant: �-Iqe Z -C' <br />Geologist: le evr ,`� <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />w.I'V1u1narN <br />Holding Temperature: <br />Method: <br />Screening Method: <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Verified Chain of Custody: ❑ Yes ❑No <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes ❑No <br />❑ Yes ❑ No <br />GROUTING or DESTRUCTION Total Depth: 7 o <br />Depth to Water: Atd rr . <br />Grout Material: Nps, c oi(� .v <br />Gallons of Grout Used: <br />[]Well Installation ❑Well Destruction <br />❑Boring Installation XBoring Destruction <br />nnrTunn 1IfCn <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity ❑Tremie Other: f4oe LI <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />eallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />Jt Bags <br />Thickest Thinnest <br />bBags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7.5 15 <br />3 <br />15 30 <br />3 <br />10 <br />20 40 <br />4 <br />12.5 2525 <br />50 <br />5 <br />15 30 <br />6 <br />30 60 <br />6 <br />17.5 35 <br />7 <br />35 70 <br />7 <br />20 40 <br />8 <br />40 80 <br />8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑ Yes 11 No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />COMPLETION ❑ Stove Pipe ❑Christie Box <br />ft. <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <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 />