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SAR�, <br /> JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> , <br /> Greatness grows here <br /> MoonitoringWell/Soil Boring Inspection Report <br /> Date: 2M/QQ 0 19 <br /> Inspector: V>-rIQ Afaskt ' CONSTRUCTION <br /> Facility Address: 1 O \ e.SC era; AL.,P— <br /> Well Address: Total Depth: <br /> WP# 00M )OH Well#: Drilling Rig Type: <br /> Soil Boring#: i 1 l-5 <br /> Drilling Company: ��rcLCp N Min 2" Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: �t,SS C Screen Length From: To: <br /> Consultant: T1XVrO_Con Filter Pack From: To: <br /> Geologist: N.c k 0'-- Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes EJ No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: 00WLETtON CC#APLEnoN <br /> Method: around Surf=* <br /> Screening Method: ar«A <br /> Verified Chain of Custody: ❑ Yes ❑No �--tt' <br /> tt. <br /> tt. <br /> SPOILS - –' <br /> Contamination Noted: ❑ Yes El No _ <br /> If yes, spoils storage Location: <br /> a�cJon — a <br /> Covered: ❑ Yes ❑No _ v <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:1 5 + -_ <br /> Depth to Water: 15 F4 0 tL .� — <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 'a o <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑BSlot Size: <br /> oring Installation Woring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity L aTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> allons Bas gallons Bags <br /> Thickest Thinnest uBags Thickest Thinnest rt Bags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 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 /> 2 10/16/2017 <br /> 1868 E. azelton Avenue I tockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />