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SANS OAO U I N Envir•onmerital Hearth Department <br /> i-e lnV,y; C I <br /> =COUNTY— <br /> `�t:Foy`" Greotnass growshere. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1I�3120 LJ Inspector: K.Saere:� CONSTRUCTION <br /> Facility Address: 6o�% E. p?6e rA,-e-e-+ <br /> Well Address: Total Depth: <br /> WP#_00403--1 Well#: Drilling Rig Type: 8` <br /> Soil Boring#:$j Min 2"Annular EHD Seal VeNfied: ❑Yes ❑No <br /> Drilling Company: T'errQCc3n <br /> Driller Onsite: R 0-cle ._P�:j Screen Length From: To: <br /> Consultant: 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 ❑No <br /> ng <br /> If yes, location and distance: height <br /> ei h-E <br /> SAMPLING ASOyE•6AOLJND <br /> Holding Temperature: COWLE ION CbMPLETiooN <br /> Method: r3r�c;nd suiaca <br /> Screening Method: trout <br /> Verified Chain of Custody: ❑Yes ❑NoIL <br /> tt- <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑Yes ❑No T = <br /> If yes,spoils storage Location: <br /> slotted — - s <br /> ""don a = A <br /> Covered: ❑ Yes ❑No =_ 7— _ <br /> Pack <br /> If yes, material: _•• <br /> GROUTING or DESTRUCTION Total Depth: �0{A (NO'k) X <br /> Depth to Water: _ - `� — n- <br /> Grout Material:Wcj CemeM- MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> • Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation L�Boring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb 4 PVC- o'r Is rulie d r <br /> gallons Bags Rallons Baggs <br /> Thickest Thinnest *Bags Thickest Thinnest d4a <br /> BentonitefCement Mix 3%Mix 5% Mix <br /> 25 s 1 s 10 Bentonite per 47 lb 1.41 2.47 <br /> s 10 2 10 20 Bentonite per 94 Ib 2.82 4.7 <br /> 7:5 15 3 15 3fl 40 9�iloEs X210 2D 4 20 4D <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 7D 7 <br /> 20 40 8 4D 80 8 <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 />