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r l.p::.l t:•V'. . <br /> `-> SAN JOAQUIN Environmental Health Department <br /> COUNTY= <br /> Greatness grows here. <br /> l� al f <br /> Monitoring <br /> Well/Soil Boring Inspection Report <br /> C��� <br /> Date: �` (,o` Z` Inspector: '" 3T C'Qk CONSTRUCTION <br /> Facility Address: A Zi--C 419-14 C <br /> Well Address: Total Depth: �tJ� <br /> WP#no q tp9 Well#: AV- Drilling Rig Type: — to vr (n4 <br /> Soil Boring#: <br /> Drilling Company: COYP <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: .5,6'h Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: (00 To: S 1 <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes []No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOI/£-GROUND <br /> CL M <br /> Holding Temperature: COwLEMN cOMPoMpoN <br /> Method: GrWna s"rfx' <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No ft- <br /> ft. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes 1:1 No <br /> If yes,spoils storage Location: sran2o <br /> Covered: ❑Yes ❑No n . <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth:300" OC-1/00IF <br /> Depth to Water: —-- <br /> Grout Material: .S°/ b g unit <br /> Gallons of Grout Used: ti SJ MATERIALS/DEVELOPMENT <br /> Qt��_J <br /> Casing Type: <br /> XWell Installation ❑Well Destructio Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction 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 �N,I remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags eallons Bags <br /> Thickest Thinnest 4Bagas Thickest Thinnest xBags Bentonite/Gement Mix 3% MIX 5% MIX <br /> ---- - ---- --------- <br /> 2.5 5 1 5 1 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 10 1 2 10 1 20 2 <br /> 7..5 15 3 15 30 3 Bentonite per 94 Ib 2.82 4.7 <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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton,California 952051 T 209 468-3420 1 F 209 464-0138 www.s*cehd.com <br />