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SAN JOAQUIN Environmental Health Department <br /> �3 COUNTY— <br /> -.o�io-,,.;' Grvotnces grows here. <br /> Monitoring Well/Soil Boring inspection Report <br /> Date: 1'1-19 Inspector: lAs� CONSTRUCTION <br /> Facility Address: '"D 3 ea KI 's" Total Depth: <br /> Well Address: Drilling Rig Type: <br /> WP# e,0 .7AD Well#: <br /> Soil Boring#: MP 1 Min 2"Annular EHD Seal Verified: ❑Yes ❑No <br /> Drilling Company: C-0 31' a Screen Length From: To: <br /> Driller Onsite: Filter Pack From: To: <br /> 1 n7 ..� <br /> Consultant: � 9 Bentonite From: To: <br /> Geologist: w Grout From: To <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> ❑No caa ing <br /> Domestic Well Onsite: ❑Yes height . <br /> If yes,location and distance: T <br /> ROU <br /> ABOVE-GND CHRt 43OX <br /> SAMPLING ookrLETiON cOMPLEnoN <br /> Holding Temperature: Ground Suiac*"r <br /> Method: grout <br /> Screening Method: �tt. <br /> ❑ tt' <br /> Verified Chain of Custody: Yes ❑No <br /> 71 <br /> SPOILS " <br /> Contamination Noted: <br /> El Yes ❑No " o <br /> .woad _ 3 <br /> If yes,spoils storage Location: aacdon .{ <br /> ❑Yes ❑No _ grew Pack <br /> Covered: e <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: Z <br /> r r/ w <br /> Grout Material: rI-e-ew4-t MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:N'y Casing Type: Feet <br /> ❑Welllnstallation O Blank Feet ScreenWeIIDestruction Slot Size: <br /> ❑Boring Installation W�Boring Destruction Bags of Cement: <br /> Bags Sand/Gravel: <br /> METHOD USED Type/Brand of Bentonite: <br /> ❑Pressure Grout []Over Drill Filter Pack Type/Size: <br /> Type of Method: <br /> ❑ Gravity E4Tremie ❑Other: <br /> Cement 471b Water Cement 941b <br /> Water allons Be s <br /> allons Be paags BentonitelCement Mix 3%Mix So Mix <br /> Thld;est Thinnest aBags Thickest Thinnest Bentonite er47lb 1.41 2.47 <br /> ae s 1 s la 2 Bentonite er 94 Ib 2.82 4.7 <br /> 5 10 2 10 20 3 <br /> 15 30 <br /> 7.5 15 3 20 40 4 <br /> 10 20 4 25 s0 5 <br /> 12.5 P5 5 30 60 6 <br /> 15 a0 6 7 <br /> 17.5 35 7 35 70 <br /> 20 4o s 40 BB B 10/16J2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 i F 209 464-0138 1 www si_ceh <br />