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v <br /> SAN JOAOUIN <br /> —COUNTY— Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 0-2-6 -z Inspector:AA9as. CONSTRUCTION <br /> Facility Address: '97,j/ /U• `r i 8� <br /> Well Address: Total Depth: <br /> WP#00 Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: Q Pccrf L Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: ✓R e✓ Screen Length From: To: <br /> Consultant: r—IZJF y Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> -' Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe El Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: � height <br /> SAMPLING ABOVEGROUND <br /> Holding Temperature: eonwLETiON ccoomPLEnoN <br /> Method: Ground Suiaca T <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑Yes ONO �TM• <br /> n. <br /> SPOILS — e <br /> Contamination Noted: El Yes ❑No r —_ <br /> If yes,spoils storage Location: alonad s <br /> saction = $ <br /> Covered: ❑ Yes ONO — graw <br /> If yes, material: Pack <br /> f ,@ <br /> GROUTING or DESTRUCTION Total Depth:_L� <br /> Depth to Water: 7-0 TM• — TM <br /> Grout Material: N MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: l9 .9�L� S <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation Slot Size: <br /> Boring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity f�Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags stations Baas <br /> Thickest Thinnest aBags Thickest Thinnest 9Bags Bentonitei ement Mix 3% MIX 5% MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 is 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 7 35 70 1 7 <br /> 20 40 a 40 a0 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 />