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SAN JOAQUIN <br /> Envir®rirnentaoeai4h Department <br /> t•� •. �� —COUNTY— <br /> �i.. cw ` Greotness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 5/0 $ Inspector: CONSTRUCTION <br /> Facility Address: Li&D t8e Aryl Q <br /> Well Address: dtlrt OM& Total Depth: <br /> WP# t2D?kz ul Well#: Drilling Rig Type: <br /> Soil Boring#:_ ell, <br /> Min 2"Annular EHD Seal Verified: El Yes El No <br /> y� <br /> Drilling Company,�: V�.l S�he:rc <br /> Driller Onsite: a ,4 W - Screen Length From: To: <br /> Consultant: t8'(rtG' Filter Pack From: To: <br /> Geologist: inn 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 , AaovE�Ra1No <br /> Holding Temperature: COWLETION cr>RMTYaox <br /> Comp=on <br /> Method: GrcaJod surface <br /> Screening Method: - ®rou2 <br /> Verified Chain of Custody: ❑Yes ❑Nott• <br /> SPOILS —. <br /> Contamination Noted: ❑Yes ❑No = .' <br /> z <br /> If yes,spoils storage Location: <br /> atoned s5 — <br /> 6acion = a <br /> Covered: ❑Yes . ❑No = RavxPW4 <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: t57 _= <br /> Depth to Water: 7E. It.- <br /> Grout <br /> Grout Material: "44 C"—"�i <br /> Gallons of Grout Used:'<:0 MATERIALS/DEVELOPMENT <br /> J Casing Type: <br /> ❑Well Installation ❑WWell Destruction Blank Feet Screen Feet <br /> El Boring Installation E oring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> �� Filter Pack Type/Size: <br /> El Gravity 09- remie ❑Other: Type of Method: <br /> Water Cement Vlb Water cement341b <br /> ilons Bas I allons Ba s <br /> Thkkest Thinnest #Bap Thickest Thinnest #Bags _Bentonite/Gement Mix 3%Mix 5%Mix <br /> z.s s o 5 10 1 1 Bentonite per 47 lb1 1.411 2.47 <br /> s 1e 2 So za z 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 50 5 <br /> 15 3o 5 30 60 6 <br /> 17.5 35 7 as 70 7 <br /> 20 40 B 40 80 1 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209468-34201 F 209464-0138 1 www.sicehd.com <br />