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SA Nc10Aa U I N <br /> Environmental Health Department <br /> —COUNTY— <br /> .. <br /> Greotness grows here. <br /> Ott oer, <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 11 22 (ICA Inspector: CONSTRUCTION <br /> Facility Address:$1$a W. f1eyenyn 6-. <br /> Well Address: Total Depth: <br /> WP# u 1� Well#: Drilling Rig Type: 1 3(y" Trem►e <br /> Soil Boring#: 012 o p cl A A 9-,—r <br /> e� <br /> Drilling Company: C�re�a �h�1'vti, Min 2"Annular EHD Seal VENfied: 11 Yes ❑No <br /> Driller Onsite: �-►�min WravnP Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist: A1v'w n Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑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 /> C�MPLEM N cHHMTY-Box <br /> Holding Temperature: co? Tifl� <br /> Method: - -- --Gmdnasartxs -- <br /> Screening Method: prcwt <br /> Verified Chain of Custody: ❑Yes ❑Nos. <br /> s. <br /> SPOILS _ <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: xtad <br /> Yi <br /> Covered: ❑ Yes ❑No iron <br /> _ a <br /> If yes, material: — •• <br /> GROUTING or DESTRUCTION Total Depth: 1o0 F- 50 -V} <br /> Depth to Water: 15 °} Is-fa U50 �a it ft. <br /> Grout Material: tqc4 cernCnq- C$Q5ak4-- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Vo.-hg. a Casing T <br /> ❑Well Installation ❑ g Ype:Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation Poring 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 XITremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bass Rallons Bags <br /> Thickest Thinnest iv Bags Thickest Thinnest 4Bags BentoniteXement Mix 3% Mix 5% ix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 is 3 15 30 3 <br /> 10 20 1 4 20 40 4 <br /> 11.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 4.0 8o 8 <br /> 21/2' �,A9S 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />