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r 2 SANJOAQUIN Environmental Health Department ) -- COUNTY Greatness 9r Monitoring Well/Soil Boring Inspection Report Date:311C12A Inspector: be CONSTRUCTION Facility Address: ?2G4 L. - S&I Z Well Address: Total Depth: WP#TES Well#: Lq t.y-1cf Drilling Rig Type: Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No Drilling Company: Cr,4t"e"[e Driller Onsite: w,i a �,� L�u•�•I ..c_ Screen Length From: To: Consultant:_ems ,s - Filter Pack From: To: Geologist: CL t.u✓lam Bentonite From: To: Grout From: To: Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box Domestic Well Onsite: ❑ Yes El No casing If yes, location and distance: WT height SAMPLING AJ30VE-GROUND Holding Temperature: COMPLETION COMPLETION Method: Ground Surfxs Screening Method: a► Verified Chain of Custody: ❑ Yes El No .�.ft• ft. —ft. SPOILS = Contamination Noted: ❑ Yes ❑No = m If yes, spoils storage Location: .lotted sac^on — Covered: El Yes ❑No ack If yes, material: GROUTING or DESTRUCTION Total Depth:�G1 -_ Depth to Water: I�' tt tt• Grout Material: vl CcdC'ei-"et.+ � MATERIALS/DEVELOPMENT Gallons of Grout Used: 13.5 5 l Casing Type: ❑Well Installation 'S?Well Destruction Blank Feet Screen Feet ❑ Slot Size: Boring Installation ❑Boring Destruction Bags Size: Cement: METHOD USED Bags Sand/Gravel: Wpressure Grout ❑Over Drill Type/Brand of Bentonite: Filter Pack Type/Size: ❑ Gravity YTremie ❑Other: Type of Method: Water Cement 471b Water Cement 941b allons Bags gallons Bags Thickest Thinnest uBags Thickest Thinnest xBags Bentonite/Cement Mix 3% Mlx 5%Mlx 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 7.5 15 3 15 30 3 10 20 4 20 40 4 12.5 25 5 25 50 5 15 30 6 30 60 6 17.5 35 7 35 70 7 20 40 8 40 80 8 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.slcehd.com