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'PUIN SA6JOAHIN <br /> o . <br /> Environmental Health Department <br /> COUNTY- <br /> 14.. r Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: L /b/�07_01nsector: i4 CONSTRUCTION <br /> Facility A dre s:_ �lO A A' n S <br /> Well Address: Total Depth: J / — <br /> WP#0 0L] 6 Well#: Drilling Rig Type: IlS 6 BT7 <br /> Soil Boring#: A I — <br /> Drilling Company: A Min 2"Annular EHD Seal Verified: Yes No <br /> Driller Onsite: � Screen Length From: To: <br /> Consultant: S 6 >%/l-rt Filter Pack From: To: <br /> Geologist: V-yy; I/1 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 casing <br /> If yes, location and distance: Wf <br /> height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION .OPIETtoN <br /> CM <br /> Method: Ground Surfak* <br /> Screening Method: J� 35 4"1grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No Q►.': 3.5 r� <br /> If yes, spoils storage Location: abttQd _ - <br /> �5� <br /> Covered: El Yes El No <br /> #ICU O T O ti = gr"'°I tea` <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:l ��S-�' '• <br /> Depth to Water:—'2 S n' tt. <br /> Grout Material: melh± ee*xGrvt <br /> Gallons of Grout Used: ^ Q � MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation XBoring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> 61J 15 11 Filter Pack Type/Size: <br /> X Gravity IgTremieV ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 41b <br /> allons Bas gallons Bags <br /> Thickest Thinnest ,Bags <br /> Thickest Thinnest "Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 s 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 15 3 15 30 3 <br /> 1. 20 4 20 40 4 n 8 <br /> 12.5 zs s 25 so s �,k% Y�' C <br /> 15 1 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 a�1,,�Cµ �rtl/'• ! 4�/�Dun O �� <br /> zo ao _ _ e 4220 ao e Q�0�'�.GC L1/i '►"'f I'l.P.�I.�C CQ� <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton California 95205 T 209 468-3420 F 209 464-0138 www.sicehd.com <br /> I I I I i <br />