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SAN JOAQUIN Environmental Health Department <br /> " r�• Iwi� <br /> COUNTY— <br /> Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 961//8" Inspector: MX4&96s1 CONSTRUCTION <br /> Facility Address:5a44ela <br /> Well Address: Total Depth: _ <br /> WP# 3�7 Well#: Drilling Rig Type: <br /> Soil Boring#: / 8i <br /> Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: 14 <br /> Driller Onsite: VO '14:;:*'14:;:*-,A,-,A, Screen Length From: To: <br /> � <br /> Consultant: G-W lL4ee - Filter Pack From: To: <br /> Geologist: Td C_ <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: WT <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION COMPLEnoN <br /> Method: Grand sutac. <br /> Screening Method: er«n <br /> Verified Chain of Custody: ❑ Yes El No �tt. <br /> it. <br /> ft. <br /> SPOILS K: <br /> Contamination Noted: ❑ Yes ❑No <br /> C <br /> If yes, spoils storage Location: slonad <br /> an — B <br /> Covered: ❑ Yes ❑No <br /> gmvw Pack <br /> If yes, material: F <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: 3Y et. — ft. <br /> Grout Material: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation JkBoring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> i�Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity )i Tremie ❑Other: Type of Method: <br /> Water a 47lb Water Cement 941b <br /> allons gallons Bags <br /> Thickest Thinnest Thickest Thinnest uBags Bentonite/Cement Mix 3% Mix 3% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 z 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 /> f j� 10/16/2017 <br /> N <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sicehd.com <br />