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ff(Pi.---°•°n.u""A SAN.DJOAQUIN vf-jimor• —COUNTY <br />\\P,.11,Fact.),V.As• Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil <br />Date: 19. Inspector: Sckid\r- <br />Facility Address: Address: L-17 E irrLi St <br />Well Address: <br />WP# Ob —SCI Well#: <br />Soil Boring#: INAIN 7 e •1 lo 1 <br />Drilling Company: S\CXi <br />Driller Onsite: tab <br />Consultant: Nana a CO`Fylvit'1) alit"2-0-1j- <br />Geologist: Uy. Mw <br />Boring Inspection Report <br />CONSTRUCTION <br />Co 4-1C rv <br />Total Depth: Mv\J\ 71 0 /(o <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: CI Yes EINo <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />Mod =La)) <br />Public Water System Onsite: El Yes LIN0 COMPLETION 0 Stove Pipe IllChristie Box <br /> <br />Domestic Well Onsite: 0 Yes 0 No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 111 Yes CI No <br />SPOILS <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />I <br />Covered: LIYes 0No MIN q ;r_1-10 <br />If yes, material: <br />GROUTING or DESTRUCTION Total DepthMiN 7/Zi10 <br />Depth to Water: 2_ ft <br />Grout Material: NNeAt mc:/tAt <br />Gallons of Grout Used: <br />0Well Installation P,Well Destruction <br />0 Boring Installation ',Boring Destruction <br />METHOD USED <br />E Pressure Grout 'Over Drill <br />Gravity Tremie 00ther: <br />casing <br />height <br />ABC— VE-GFIOUNO <br />CO PAP LET N <br /> <br />CFiFIISTY-B0 X <br />COMPLETION <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest # Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 , <br />7.5 15 3 15 30 tto C) <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 />1/0/0 Jo(cilitiv3) N tA)17. 0 (096(14 <br />Bentonite/Cement Mix 3% Mix °.41Mix <br />Bentonite pe47 ) 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />c-P bey <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com