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SAN IDAQUIN <br /> . couNTY— Environmen Health Department <br /> �OitT ' Greatness grows Mere. <br /> —� <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: IGW✓11V1.2 CONSTRUCTION CASiV-t r`nsc l <br /> Facility Address: i (per 7 Jljd. <br /> Well Address: 2?,ppLt�c,_;SE' A�)p_, Total Depth: ;?(0 c <br /> WP# ���� rj , `7 Well#: -�j'� Drilling Rig Type: 0 ��p✓c,lp <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: <br /> Drilling Company: 1(�e S � .Yes ❑No <br /> Driller Onsite: �-a v�. Screen Length From: a5l To: <br /> Consultant: C7 !ju _L rlyl .r->}a, i4s,z,�- 1�Filter Pack From: Ll I• TO:�� <br /> Geologist: a Bentonite From:a3(Q, To: <br /> Grout From: To:�� <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes ❑No <br /> casing <br /> If yes, location and distance: �T height <br /> SAMPLING - <br /> AWYE-GFtOi.IND C.f•'FilSi'l-3oX <br /> Holding Temperature: CO&FLETJoN cohlPtE770N <br /> Method: GMdrXJ sutacs <br /> Screening Method: provi <br /> Verified Chain of Custody: ❑ Yes ❑No ft- <br /> SPOILS _ <br /> a= a w <br /> Contamination Noted: El Yes ❑No - -- s <br /> If yes,spoils storage Location: = C <br /> .o <br /> siorad <br /> Covered: ❑Yes ❑No72 Packn <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: a� <br /> Depth to Water: <br /> Grout Material: yxeo-+ C9*TX94A 4 <br /> Gallons of Grout Used: (�rj� MATERIALS DEVELOPMENT <br /> Casing Type: " � S+etj Gast"�y <br /> Well Installation E]Well-Destruction Blank Feet Screen—j Feet <br /> [�. <br /> ❑Boring Installation ❑ Slot Size: Q of <br /> Boring Destruction Bags Size: <br /> Cement: 1:6 <br /> METHOD USED Bags Sand/Gravel: I H bac S <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: /Q �Qewpo s <br /> Filter Pack Type/Size: <br /> ❑ Gravity >dzremie ❑Other: Type of Method: <br /> W <br /> aterCement 471b Water Cement 941b <br /> Ba gallons Bags <br /> #Bags Thickest ThinnM16 <br /> Sentonite/Cement Mix 3%1<it]ix 5%Mix <br /> 1 5 18 Bentonite per 47 Ib 1.41 2.47 <br /> 2 15 30 Bentonite per 94 Ib 2.82 47 3 15 30 <br /> � c <br /> 10 20 4 20 40 <br /> 12.5 25 5 25 50 <br /> 15 30 6 30 60. <br /> 17.5 35 7 35 70 1 7 <br /> 20 40 8 40 80 1 8 <br /> 10/16/2017 <br /> 1888 E. Hazelton Avenue I Stockton,Calftmlia 95205 1 7 209 468-3420 1 F 209 464-6138 1 wvw,nv.sicehd.com <br />