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fia S N1JOAOUIN <br />sit —COUNTY <br />Greatness grows here. <br />Environment Health Department <br />1 dictiivu2,4r- Boring Inspection Report <br />CONSTRUCTION <br />0 Yes 0No Verified Chain of Custody: <br />SPOILS <br />LI Gravity remie 0Dther: <br />10/1 6 / 2 017 32 baFys <br />188 E. HaZeltori Avenue Stockton, California 95205 1 1 209 468-3420 I F 209 464-9133 1 www.sicend.com <br />Soil Boring#: <br />Drilling Company: .2 Lex) bsr% t <br />Driller Onsite: PiradvA le-- <br />Consultant: Gyro tRAPLA 2 e.Aro <br />Geologist: Amciv-r.A.Ar 1)onn. <br />Public Water System Onsite: 0 Yes ON° <br />Domestic Well Onsite: 0 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: 0 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 51 <br />Depth to Water: I D i <br />Grout Material: cht/ntAA <br />Gallons of Grout Used: <br />OWell Installation '514Vell. Destruction <br />Boring Installation 0 Boring Destruction <br />METHOD USED <br />OPressure Grout 0Over Drill <br />.casing <br />height <br />ABOVE-GROUND <br />COWLEMN <br />f t. <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 />galions <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />-sags <br />Thickest Thinnest # Bag Thickest Thinnest # Bags <br />2.5 1 10 1 <br />10 2 10 20 2 <br />7.5 15 3 15 30 3 <br />10 20 4 20 40 4 <br />12.5 25 25 50 <br />15 30 6 30 60 . 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb <br />Bentonite per 94 lb 2.82 <br />1.41 2.47 <br />4.7 <br />Monitoring VVell/Soil <br />Date: %/I S Inspector: ?_)Z,V1i(4,vv‘.‘ vtz, <br />Facility Addrass: L-15_ IA) • C LAdict, <br />Well Address: <br />\AN# no3ssa Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />COMPLETION D Stove Pipe <br />Yes 0No <br />To: <br />To: <br />To: <br />To: <br />D Christie Box