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SAN JOAQUIN <br />COUNTY— <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />�< <br />Date: IZ zZ Inspector: t Ir <br />CONSTRUCTION <br />Facility Address: Aiy-qg"C twc..y <br />Thickest Th <br />Well Address: <br />Total Depth: <br />WP# 45 -LOQ Well#: <br />Drilling Rig Type: <br />Soil Boring#: (3 <br />5 <br />Drilling Company: c.a li Jvr!ti (rGp� <br />Min 2" Annular EHD Seal Verified: <br />Driller Onsite: T7f& 1 tL4-VL <br />Screen Length From: <br />Consultant: (&0�6A-&-kzir^,, <br />Filter Pack From: <br />Geologist: k W.[ 5'1 -A,0\.Y1 <br />Bentonite From: <br />7.5 <br />Grout From: <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />conn c <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />❑ Yes xrNo <br />❑ Yes 'ff-No <br />❑ Yes ❑No <br />❑ Yes ff-N-o <br />❑ Yes ❑No <br />I <br />GROUTING or DESTRUCTION Total Depth: 10 <br />Depth to Water: ' V� <br />Grout Material: 1 <br />10.7 W�- C t, <br />Gallons of Grout Used: X-( S�ct�/y- <br />❑Well Installation ❑Well Destruction <br />El Boring Installation Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />Water <br />gallons <br />Cement 47Ib <br />Bas <br />water <br />Rallons <br />Cement 94 lb <br />Bags <br />Thickest Th <br />t <br />x s <br />Thickest Thinnest <br />b Bags <br />2.5 <br />5 <br />5 10 <br />1 <br />S <br />0 <br />2 <br />10 20 <br />1 <br />7.5 <br />15 <br />3 <br />15 30 <br />3 <br />10 <br />20 <br />4 <br />20 40 <br />4 <br />12.5 <br />25 <br />5 <br />25 50 <br />5 <br />15 <br />30 <br />6 <br />30 60 <br />6 <br />17.5 <br />35 <br />7 <br />35 70 <br />7 <br />20 <br />40 <br />8 <br />40 80 <br />8 <br />COMPLETION ❑ Stove Pipe <br />❑ Yes El No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />tt. <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 2.821 4.7 <br />10/16/2017 <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 />