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SAN1:JOAQU1Nb EnvironmerASHealth Department <br /> —COUNTY— <br /> �S,;rca~� Greatness grows here <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: V, Is Inspector: I,, CONSTRUCTION <br /> Facility Address: 11 i op M,.,-p64 1&,K " <br /> Well Address: Total Depth: llfb <br /> WP# —Wel I#:S&,-r-%.j j cr-^wa.Drilling Rig Type: Ao I Lo".., S+,,,.,.. <br /> Soil Boring#: SPI Min 2"Annular EHD Seal Verified: P Yes ❑No <br /> Drilling Company: (�aG (�_Q,-�/1�� <br /> Driller Onsite: r�7.lx v Screen Length From:s :_t To: it.-Po' w Pb <br /> Filter Pack From:y FC 2.t^ To: i3I_F{, <br /> Consultant: B✓'s.�.cc.. Arssbc-u�,4ts�1>v.L. i-- <br /> Geologist: Tte Bentonite From:3 + I To: <br /> Grout - From:3!1%, i f} To:4 ••e-4e.,- <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION 21tove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes,location and distance: height <br /> _V <br /> SAMPLING _ ABOVE-GROUND w <br /> � NHolding Temperature: COMP.moN C Q <br /> Method: Grwnd s"wf"" <br /> Screening Method: P, grout <br /> Verified Chain of Custody: ❑ Yes ❑Nott• <br /> tt. <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑ Yes EJ No .= <br /> If yes,spoils storage Location: ' = <br /> sloth Yi <br /> ttscacna <br /> Covered: ❑ Yes ❑No <br /> gra Pack <br /> If yes, material: <br /> fp� GROUTING or DESTRUCTION Total Depth: 2d�t5 <br /> VV Depth to Wate r t 0 Fb �• "` � �- <br /> Grout Material: e\e& <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: so Casing Type: Sc j, 41) <br /> ❑Well Installation CKNell Destruction Blank 6. 3 Feet Screen -1 Feet <br /> Slot Size:- _ 92- <br /> El Boring Installation El Boring Destruction Bags of Cement: I brc tib z b•� t.3-f4, <br /> METHOD USEDBags Sand/Gravel: 4.y tL&5 �.�t,� <br /> . <br /> �� <br /> ❑Pressure Grout NOver Drill Type/Brand of Bentonite: C_&A-c,4 <br /> � Filter Pack Type/Size: *VZ, <br /> ❑ Gravity CYfremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> ailons Bas gallons Bags <br /> Thickest Thinnest zBags 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 1s 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 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 Stockton, California 95205 1 'T 209 468-3420 I F 209 464-0138 www.sicehd.com <br />