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JOAQUIN Environmental Health Department <br /> —COUNTY <br /> °9kjF0 Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: �2 Z 9 Inspector: I ;GL 4CONSTRUCTION <br /> Facility Address: -3w5• CGt ' t <br /> Well Address: Total Depth: <br /> WP# 00 2 3 Well#: Drilling Rig Type: <br /> Soil Boring#: 7 — G leo —c <br /> Drilling Company: Min 2"Annular EHD Seal Verified: L1 Yes ❑No <br /> Driller Onsite: ` Screen Length From: To: <br /> Consultant: ✓Jl,. Filter Pack From: To: <br /> Geologist: 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 ABCNE-GROUND <br /> Holding Temperature: 0011FLETION coMP�tEnoN <br /> Method: Ground Sirfac* <br /> Screening Method: tires <br /> Verified Chain of Custody: ❑ Yes ❑No —n' <br /> n. <br /> n. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: 1 I slotted _ B <br /> "I 1 t "c^Jon „. <br /> Covered: El Yes ❑No —�pQ <br /> gn++sl pack <br /> If yes, material: (l e J 6 I A <br /> GROUTING or DESTRUCTION T tal Depth: I I Q :5`67 <br /> Depth to Water: 02,1 0n- IF <br /> n' <br /> Grout Material: AAK tt( '46 ' <br /> Gallons of Grout Used: 3 S 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 /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity NTremie ❑Other: Type of Method: <br /> 1-1 <br /> Water Cemen 471 Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest uBags Bentonite/Cement Mix 3% Mix 3% 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 /> / q p� 6 bi�S 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 />