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SAN JUAQUIN <br /> Environmental Health Department <br /> SS`•I'=_ " —COUNTY <br /> 1 _ <br /> `FlewozFl, Greatness grows here. <br /> �e�1s Monitoring W <br /> , e <br /> ll/Soil Boring Inspection Report <br /> Dater�- S � Inspector: CONSTRUCTION <br /> Facility Address: 3qo 1Ow� (� <br /> Well Address: L-Pt'CNRAP &'Ok N Total Depth: <br /> WP# �V( � (� �\2�\ Well#: Drilling Rig Type: <br /> 16 il-B~ ltjw �L Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: In Screen Length From: To: <br /> Consultant: wL �J���NJwEF1� M217 Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ONO COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes 12(No casing <br /> If yes, location and distance: --��� height <br /> SAMPLING ABOVE-GROUND <br /> COMPLETION CF6ii5iY-eOX <br /> Holding Temperature: COMPLETION <br /> Method: Ground sulac0 + <br /> Screening Method: gran <br /> Verified Chain of Custody: ❑ Yes Ell No 1 ft <br /> tt. <br /> SPOILS S <br /> u <br /> Contamination Noted: El Yes ONO <br /> If yes,spoils storage Location: <br /> abnad � <br /> Covered: ❑ Yes ENO •�cBcngraval Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: 3�1 <br /> Depth to Water: v. 'Lb <br /> Grout Material: n1G1h (EM �►1t Gallons of Grout Used: "LS MATERIALS/DEVELOPMENT <br /> �- cE �R�E oSu QSK Casing Type: <br /> ❑Well Installation lUWell Destruction p't"T Blank Feet Screen Feet <br /> ❑Boring Installation ❑ Slot Size:Boring.Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> 4Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags gallons Bags <br /> Thickest Thin st #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3°/uMIX 5%MIX <br /> 2.5 s 1 5 10 1 Bentonite per 47 lb 1 Al 2.47 <br /> s la z 10 zo z Bentonite per 94lb 1 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 a <br /> 10/16/7017 <br /> �1....1.4..... l...I:C.....I..nCnn& I T nnn AQO 7Ann 1 L nAn A P A A400 1 ..........1__11 <br />