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SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> (;reotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 3 20 20 inspector: S ur—hir cd CONSTRUCTION <br /> Facility Address: 506 ozusz <br /> Well Address: Total Depth: <br /> WP# nOPO6?S Well#: Drilling Rig Type: <br /> Soil Boring#:MW 1-21 N14 <br /> Drilling Company:_ SCagC� <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite:: Screen Length From: To: <br /> Consultant: 4,17,1q641iet) Filter Pack From: To: <br /> Geologist: 8_0j 2 t/ 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 ONO casing <br /> If yes, location and distance: F4- height <br /> SAMPLING ABOVEGROUND <br /> COWLS ION COMPLETION <br /> Holding Temperature: coMpiErioN <br /> Method: °round 8vlacv <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No tt• <br /> tt. <br /> SPOILS — <br /> 0 <br /> Contamination Noted: ❑Yes ONO <br /> If yes,spoils storage Location: aiotud — <br /> axdon <br /> Covered: ❑ Yes ❑No <br /> gravel Pack <br /> If yes, material: _= <br /> GROUTING or DESTRUCTION Total Depth; <br /> DepthtoWater: ^ �I- 27 tt• tt <br /> Grout Material: iyeAt <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 <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity �ITremie ❑Other: Type of Method: <br /> Water Cern€nt4 Ib Water Cement 941b <br /> allons Ba gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 to 1 Bentonite er47lb 1.41 2.47 <br /> 5 20 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 30 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 80 8 <br /> 40Gry, 05 � 1VI.f,Y 6 WY MV 4&f7Uc"livw, 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 />