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alU 1.Y•. <br /> - SAN.,t R <br /> JOAQUIN Environmeial Health Department <br /> —C OUNTY— <br /> •,".'sr�,r' `%� Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �OIi1 �16EU Inspector: UtX� \AYl� UAJ CONSTRUCTION <br /> Facility Address:ItA\ a <br /> Well Address: A\ F W&AAUr wa Total Depth: <br /> Weft 00 8q 3 Well#: Nl 2 Drilling Rig Type: <br /> Soil Boring#-. Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Screen Length From: To: <br /> Driller Onsite: Filter Pack From: To: <br /> Consultant: M Bentonite From: To: <br /> Geologist: Grout From: To: <br /> Public Water System Onsite: ❑Yes ONO COMPLETION ❑ Stove Pipe []Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes,location and distance: height <br /> SAMPLING ABOVE-GROUND crwlsrreox. <br /> Holding Temperature: COWLEn°N COMPUTION <br /> Method: ors <br /> Screening Method: <br /> tt. <br /> Verified Chain of Custody: ❑ Yes El No It, <br /> _Tt. — <br /> SPOILS x r m <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: ° <br /> $btt$d <br /> $*Coen 15 -- <br /> Covered: ❑ Yes ❑No ta$vw Pads <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: 3q - F� TM <br /> fG <br /> Depth to Water: <br /> Grout Material: (,J41bMj 1 4a" lh bAp MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:�Al1AY1 S Casing Type: <br /> ❑Well Installation ?Well Destruction vte11 Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED �Xp�6SIV� Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> 1t'Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bags allons Ba s <br /> Thickest Thinnest #Bags Thickest Thinnest ueags Bentonitelcement Mix 3% Mix 5%Mix <br /> zs 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94lb 2.82 4.7 <br /> 7.5 15 15 30 3 <br /> 30 20 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 a 40 e0 a 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br />