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SAN J O A Q U I N Environmental Health Department <br /> —COUNTY <br /> `Pq:rFoaT Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: jVA,566*24 CONSTRUCTION %s., 44-1-W fe <br /> Facility Address: 147S-e- 'eqr.� 0-to <br /> Well Address: Total Depth: <br /> WP#�0 3$!!r 5l Well#: Drilling Rig Type: CSF 7 S <br /> Soil Boring#: 2.F— If'—IS- <br /> Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Drilling Company: GW-6)c <br /> Driller Onsite: r° Screen Length From: To: <br /> �COrv� Filter Pack From: To: <br /> Consultant: <br /> Geologist:�.e.+,� <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> iii <br /> SAMPLING ABOVE-GROUND _ <br /> Holding Temperature: CONFLETION CCXW EncN <br /> Method: G=nd Sudan '+ <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes E]No �ft. <br /> fi. <br /> tt. <br /> SPOILS <br /> — - o <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: slonad <br /> teccon <br /> Covered: ❑ Yes ❑No <br /> If yes, material: ' <br /> GROUTING or DESTRUCTION Total Depth: �Od <br /> Depth to Water: 12 ft• ft. <br /> Grout Material: AJA*y4-cemw_4 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation;$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 Egfremie ❑Other: Type of Method: <br /> at C ent 471b Water Cement 94 lb <br /> Bas gall ons Bags <br /> Thickest Thinnest tl"Ba gs Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 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 70 7 <br /> 20 40 8 40 80 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 />