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SAN JOAQUIN Environmental Health Department <br /> COUNTY— <br /> Greatness grows here. <br /> MonitoringWell/Soil Boring Inspection Report <br /> Date: /9 Inspector: '/(�• CONSTRUCTION <br /> Facility Address: 2 6'� La hl-o . �-d f—' S ��'n Q <br /> Well Address: Total Depth: n' I u <br /> W P# � Well#: Drilling Rig Type: /nu� ✓"1Ky 3 S M PS— 15 <br /> Soil Boring#: <br /> Drilling Company: (/y' , , Min 2"Annular EHD Seal Verified: El Yes []No <br /> Driller Onsite: k Screen Length From: To: <br /> Consultant: P ' <br /> Filter Pack From: To: <br /> Geologist: k'41,Wyl,V 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 /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION �PLEnoN <br /> Method: around Surface <br /> Screening Method: &I of out <br /> Verified Chain of Custody: ❑ Yes El No <br /> n. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No r" <br /> If yes, spoils storage Location: .toted _ C <br /> sac0on x^ <br /> Covered: ❑ Yes ❑No <br /> g-vot pack <br /> If yes, material: U_ff <br /> GROUTING or DESTRUCTIO Total Depth:Depth to Water: 1S ft. n' <br /> Grout Material: A 4�LCi'w e"' <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 55. oko lo✓lS <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> []Boring Installation E4Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ GravitylTremie ❑Other: Type of Method: <br /> Water Cement 71b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest ttBags Thickest Thinnest #Bags 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 25 225 50 5 <br /> 15 30 6 1 30 1 60 6 <br /> 17.5 35 7 1 35 1 70 7 <br /> 20 40 8 40 1 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.s'cehd.com <br />