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SAN.-JOAQUIN <br />—COUNTY— <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: <br />Inspector: LQ-Q�31� <br />CONSTRUCTION <br />Facility Address:__\_0M) <br />��i `, <br />�qt�*o <br />Well Address: '�Qc�� <br />v.�P"` ti,)F�W� <br />Total Depth: <br />WP# <br />Well#: <br />Drilling Rig Type: <br />Soil Boring#: <br />S -Z-0 <br />wV_ <br />1 <br />5 <br />M" Annular EHD Seal Verified: <br />ln 2 <br />Drilling Company: <br />��f��`� <br />20 <br />Driller Onsite: <br />7.5 <br />Screen Length From: <br />Consultant: <br />15 <br />Filter Pack From: <br />Geologist: (�Q,�� <br />10 <br />Bentonite From: <br />4 <br />20 <br />Grout From: <br />Public Water System Onsite: jLl Yes []No <br />Domestic Well Onsite: ❑ Yes 4N0 <br />If yes, location and distance: <br />SAMPLING �' <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes ❑No <br />SPOILS <br />Contamination Noted: ❑ Yes C No <br />If yes, spoils storage Location: <br />Covered: \] Yes ❑No <br />If yes, material: SL' <br />GROUTING or DESTRUCTION Total Depth.—t5 11 , 7,5 <br />Depth to Water:— <br />Grout Material: <br />Gallons of Grout Used: <br />[]Well Installation ❑Well Destruction <br />❑Boring Installation Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />eallons <br />Cement 94 lb <br />BaFs <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />#Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12,5 1 <br />50 <br />5 <br />15 <br />(J2 <br />T <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />6 <br />COMPLETION ❑ Stove Pipe <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />M <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 - <br />,rtp r"'Vitt..3 . 10/16/2017 <br />RC." tAwo <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 />q*j av tjvv� . <br />