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SAN ;JOAQUIN <br /> —COUNTY Environmental Health Department <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Datel_\\ 5"�NZp2�IFispector: CONSTRUCTION N/(J <br /> Facility Address:?'1 Co k� vJ P\S <br /> Well Address: /\ )/A Total Depth: <br /> WP# �{"�33R Well#: A.J� Drilling Rig Type: <br /> Soil Boring#: Z�c - Z-Z- " C7 1..D Min 2"Annular EHD Seal Verified: ❑ Yes El No <br /> Drilling Company: IS^VQ eA.Cs\ <br /> 6G1�!'L Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: 061 eel Bentonite <br /> Pack From: To: <br /> Geologist: _'T`�� Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 11No COMPLETION ElStove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes /No <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: CO&FLECION CCWLETION <br /> Method: Grwnd sutaas <br /> Screening Method: nroLn <br /> Verified Chain of Custody: ❑ Yes ONO �ft. <br /> ft. <br /> f?. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: slon&d = - <br /> Covered: ❑ Yes ❑No s*=cn __ <br /> � = . s� <br /> If yes, material: <br /> _ .. <br /> GROUTING or DESTRUCTION Total Depth: ir <br /> Depth to Water: <br /> Grout Material: NEAT c fct-`F_P.1 t <br /> Gallons of Grout Used: � ' � Gl qY MATERIALS/DEVELOPMENT /1)/� <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 /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity C�Tremie ❑Other: Type of Method: <br /> Water /Cement 471b Water Cement 941b <br /> allons Bas gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3%Mix 5% Mix <br /> 2.5 s 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.s'cehd.com <br />