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SAN-JOAQUIN Environmental Health Department <br />—COUNTY— <br />_,.-. <br />_ Greatness grows here. <br />/� ��y Monitoring Well/Soil Boring Inspection Report <br />61Date: 10' `�` `b Inspector: CONSTRUCTION <br />Facility Address: '-71"> 506 KcLSsS <br />Well Address: Total Depth: N <br />WP# 0o +Dc\ Well#: Drilling Rig Type: 7 ©� ` Gt."Js�' <br />Soil Boring#: S1 I <br />Drilling Company: yMin 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Driller Onsite: Screen Length From: To: <br />Consultant: Filter Pack From: To: <br />Geologist: IQ_Ot- 0"*'\ Bentonite From: To: <br />� I Grout From: To: <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 />gpnn q <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: <br />❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: ' <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity XTremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bags <br />Water <br />allons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />xBags <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />1 <br />5 10 <br />1 <br />5 10 <br />2 <br />10 20 <br />2 <br />7,5 15 <br />3 <br />15 30 <br />3 <br />10 20 <br />4 <br />20 40 <br />4 <br />12.5 25 <br />5 <br />0 <br />5 <br />15 30 <br />30 60 <br />6 <br />17.5 35 <br />35 1 70 <br />7 <br />20 40 <br />40 1 80 <br />8 <br />casing <br />height <br />ht <br />D ct�>m aox <br />GOM?f:ET1oN COMPLEMON <br />G=nd suracs <br />proof <br />tt. <br />n. <br />ft. <br />— o <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 />Nu�- '33, <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.sicehd.com <br />