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SAN JOAQUIN <br />R , <br />COUNTY— <br />O90 r`P" Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 14�*/1/-'Inspector: /1'4�n^ <br />Facility Address: 1#16op 1✓b.4fA 1(--4- <br />Well <br />(jWell Address: <br />WP# OD F7"b T Well#: <br />Soil Boring#: S1 QZ <br />Drilling Company: he/7• <br />Driller Onsite: ,])Sy+ e <br />Consultant: /1?G� fig GccsrY ��+5( tu�0 <br />Geologist: <br />CONSTRUCTION <br />Total Depth: _ <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified <br />Screen Length <br />From: <br />Filter Pack <br />From: <br />Bentonite <br />From: <br />Grout <br />From: <br />Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe <br />Domestic Well Onsite: ❑ Yes El No <br />If yes, location and distance: <br />cnnnal ini(�, <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes ❑ No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: *. IS � <br />Depth to Water: L/1-/ 1 <br />Grout Material: Ni(wl-eLO ' 1(' <br />Gallons of Grout Used: <br />❑Well Installation E�]Well Destruction <br />❑Boring Installation LRBoring Destruction <br />METHOD USED <br />❑PPressure Grout ❑Over Drill <br />LYGravjty VTremie ❑Other: <br />lS of <br />Water <br />allons <br />Cement 471b <br />Bas <br />water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />#Bags <br />Thickest Thinnest <br />4Bags <br />2.5 5 <br />5 <br />10 <br />1 <br />5 10 <br />2 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 15 <br />5 <br />25 <br />50 <br />5 <br />15 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 35 <br />7 <br />35 <br />70 <br />7 <br />20 40 <br />8 <br />40 <br />80 <br />8 <br />df - -0 - <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <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 />10/16/2017 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.secehd.com <br />