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SAN JOAQUIN Environmental Health Department <br /> COUNTY--- <br /> Greatness grows here <br /> y Q Monitoring Well/Soil Boring Inspection Report <br /> Date: 142 )p Inspectors tXk/ -tt7YI -CONSTRUCTION <br /> Facility Address: S7 <br /> Well Address: Total Depth: n I <br /> W P# n 0�9 V "Z WL tell#: Drilling Rig Type: S'T ' 4 <br /> Soil Boring#: i ,l L, Fi 3.fly ,h S, r�( i�, ,f Z Min 2"Annular EHD Seal Verified: ❑ Yes F-]No <br /> Drilling Company: Ky- kl� A�cnclrx C' <br /> Driller Onsite: <br /> -r,` Screen Length From: To: <br /> Consultant: -rA c ; t,-6j, Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes []No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes E]No casing <br /> If yes, location and distance: height <br /> SAMPLING ASCVE-GROUND <br /> Holding Temperature: al`V�1ON CCCC LE-nCN <br /> Method: Ground Surface <br /> Screening Method: Drat( <br /> Verified Chain of Custody: ❑ Yes [7J No �tt' <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No <br /> If yes, spoils storage Location: slcnad <br /> a*c:cn <br /> Covered: ❑ Yes El No I = 9-11"1gl ' 10 Pack <br /> If yes, material: �7' i-S a" <br /> GROUTING or DESTRUCTION Total Depth: I 3 50 <br /> Depth to Water: - <br /> tt. <br /> Grout Material: �;;"(} { C'ey e'h4sl o t <br /> Plb I <br /> rl 1 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: C � i Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation I913oring Destruction <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> El Gravity STremie I90ther: i! : _1," I Type of Method: <br /> water Cemen 471b/ water Cement 94 lb <br /> gallons Bas gallons Bads <br /> Thickest Thinneet 9Bags Thi&est Thinnest .Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 51 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 10 2 10 20 1 Bentonite per 94 Ib 2.82 4.7 <br /> ZS 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 5 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 4p 80 8 <br /> 10/16/2017 <br /> 1868 E Hazelton Avenue I Stockton. California 95205 1 T 209 468-3420 F 209 464-0138 wmv.sicehd com <br />