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nUl/y <br /> N � SA N,J 0 A Q U I N Environmental Health Department <br /> j COUNTY <br /> �v Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 7-31&rx1 Inspector: CONSTRUCTION <br /> Facility Address: Ary.-.- <br /> Well Address: Total Depth: <br /> WP#6$0`t097 f Well#: Drilling Rig Type: <br /> Soil Boring#: Aa B3. A Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: 7'Yfit co«. <br /> Driller Onsite: ,�..� Screen Length From: To: <br /> {y4 ev&L- Filter Pack From: To: <br /> Consultant:_�' <br /> Geologist: ,dsee- ,vie- t Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes EJ No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ASOVE-GRCUND <br /> Holding Temperature: COWLETION c�t.FnoN <br /> Method: Groan°Surface <br /> Screening Method: 1521, orMA <br /> Verified Chain of Custody: ❑ Yes El No �tt. <br /> tt. <br /> tt. <br /> SPOILS . <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: slatted K. — B <br /> axion r _ <br /> Covered: ❑ Yes ❑No = QMVW Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: Z0 <br /> Depth to Water: 7 1 <br /> Grout Material: /►��sfce�..tyr" <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> Boring Installation g <br /> ❑ <br /> C�Borin Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ElGravity 52Tremie ❑Other: Type of Method: <br /> er Wrent 71b water Cement 941b <br /> allon f Bas eallons Bags <br /> Thicker Thinnest age 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 a 20 40 a L <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 7/lr.041• <br /> 17.5 35 7 35 70 7 /y <br /> 20 40 8 40 80 8 "/ �w pew qr�T�r'"`,• <br /> o- 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 />