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SAN JOAQUIN Environmental Health Department <br /> COUNTY — <br /> Greatness <br /> OUNTY —Greatness grows here. <br /> I I MonitoringWell/Soil Boring Inspection Report <br /> Date: l InspelcIt�o�r1 )10'4�1 A /�f� ' CONSTRUCTION <br /> Facility Address: l� l�Y• LA �p P- <br /> Well Address: Total Depth: <br /> WP# 00 3 !T(61 Well#: Drilling Rig Type: C7 S�i y(r Gl-NtL <br /> Soil Boring#: 13 1,,6216'35 �6 ���g9/�/�Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: /Adch Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes 1:1 No casing <br /> If yes, location and distance: height <br /> SAMPLING � <br /> —�0 MioVE- ROVNo cr8sm430x <br /> Holding Temperature: t CONPLE ION COMPLEN <br /> Method: I - °`°""°su<r�. TIO <br /> Screening Method: 6-5-10 cry <br /> Verified Chain of Custody: El Yes 11 No �j'1 - �l —n' <br /> n <br /> ft. <br /> SPOILS <br /> y <br /> / <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: <br /> v ) aac�on _ -- <br /> Covered: ❑ Yes El No <br /> If yes, material: x <br /> GROUTING or DESTRUCTION Total Depth: [b 6 �f ! . <br /> Depth to Water: Ql�'�6 n• <br /> tt. <br /> Grout Material: &"—a 66We—A1 <br /> Gallons of Grout Used: I l0 a 9-110 AJ, MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> El Boring Installation 5413oring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill <br /> t�r <br /> 610 0 Filter Pack Type/Size: <br /> I�Gravity MTremle Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Rallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest 4Bags 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 /> 60 Io.`bits �0 L-4y j 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sicehd.com <br />