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SAN. JOAQUIN Environmental Health Department <br /> "` --COUNTY-- <br /> �`��1cP� Greatness grows here. <br /> 4 Q Monitoring Well/Soil Boring Inspection Report <br /> Date: 17 Inspector:I ly OSA CONSTRUCTION <br /> Facility Address: T-31 Soerr <br /> Well Address: Total Depth: -I 1J <br /> WP# 3 Well#: Drilling Rig Type: CLI'awr`�' <br /> Soil Boring#: <br /> Drilling Company: KI/�A.�aJ'1 SoU�o�'i,¢1 Min 2"Annular EHD Seal Verified: 11 Yes El No <br /> Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: tr0���iVt S o U Filter Pack From: To: <br /> Geologist: k/&-VYU-- Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 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: COIFLETION coMPLEnOIJ <br /> Method: around Sunlws <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No ,—n' <br /> it. <br /> tt. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes El No <br /> If yes,spoils storage Location: sic <br /> Covered: E] Yes El No el,� I amen <br /> $z% <br /> ��� <br /> l0 <br /> If yes, material: �j <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: '.Z -�� ovt $ 64,15 n• —ft. <br /> GroutMaterial: <br /> Gallons of Grout Used: 0 t,A�j . MATERIALS/DEVELOPMENT <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 /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ' Gravity I$Tr i� ❑Other: Type of Method: <br /> � <br /> Water Cement 471 Water Cement 94 lb <br /> allons Bas eallons Bags <br /> Thickest Thinnest 118ags Thickest Thinnest 2Bags 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 7 35 70 7 <br /> 20 40 8 40 80 8 <br /> 142 (3 b�S 10/16/2017 <br /> 1868E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.s*cehd.com <br />