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UIN <br /> SA NrJ 0 A 0 U I N Environment Health Department <br /> Z <br /> "` -- COUNTY - <br /> a, �j Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: A/aji�-E^- CONSTRUCTION <br /> Facility Address: , <br /> Well Address: Total Depth: 26l <br /> WP# oo,�'p// Well#: AS-8 Drilling Rig Type: U04 rb-hq-71 e 31y <br /> Soil Boring#: <br /> Drilling Company:yellow/�uc�� Min 2" Annular EHD Seal Verified: 11 Yes El No <br /> Screen Length From: 'Z(b S <br /> To: 2 AFS" jxi ea s�,i <br /> Driller Onsite: /.w <br /> Consultant: (�Sy�L e'..so/ v ?wc- Filter Pack From: 'z(vl To: ZSZ• $ �����w� <br /> Geologist: Bentonite From:zSz.g'� To; zyq•y` P���..�s,G/lsK� <br /> Grout From:2.gT(.q To: C) <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑NoWT <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND CHRISW_ <br /> Holding Temperature: COWPlETION 00MPLEMN <br /> Method: Ground surf"' <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> tt. <br /> tt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes El No = <br /> If yes,spoils storage Location: stox�d <br /> &�cn — B <br /> Covered: ❑ Yes ❑No = 9-911 i <br /> ack <br /> If yes, material: <br /> x = <br /> GROUTING or DESTRUCTION Total Depth: 264 =_ <br /> Depth to Water: tt• tt' <br /> Grout Material: Neth 64^e4 <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: S feeC 2 <br /> NWell Installation ❑Well Destruction Blank 2310 Feet Screen 5 Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: •o zo <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: 7�2LS <br /> 5IPressure Grout ❑Over Drill Type/Brand of Bentonite: ir% 'rDPWL rnejCunn <br /> Filter Pack Type/Size: <br /> ❑ Gravity XTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b hSer✓w-j <br /> 0wkI ' °Jfv or. (/* <br /> allons Bas gallons Bas VV 11 <br /> Thickest Thinnest tlBags Thickest Thinnest »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 s0 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 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 />