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rt. <br />grout <br />ft <br />slotted <br />aaclon <br />gravel pack <br />ft <br />SANA,JOAQUIN <br />COUNTY- <br />Greatness grows <br />Environmental Health Department <br />'S.'",11.1F0W4 <br /> <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 3-"6-'1° " Inspector: Adser•o- <br />Facility Address: /WV 417.1141,-, (-442 7 <br />Well Address: <br />WP# OD Sr/ 5- Well: <br />Soil Boring#: C7-/O <br />Drilling Company: /7.4,..0(014 <br />Driller Onsite: jt/a•ft- <br />Consultant: A.4..4— Coo) <br />Geologist: /vr, <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: LI Yes 0No <br />To: <br />To: <br />To: <br />To: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br />From: <br />Public Water System Onsite: D Yes ON° COMPLETION 0 Stove Pipe 111 Christie Box <br /> <br />Domestic Well Onsite: El Yes EN° <br />If yes, location and distance: <br />casing <br />height <br /> <br />SAMPLING <br />Holding Temperature: <br />Method: <br /> <br />CHRISTY-BOX <br />COMPLETION <br />GnxInd Surfacs <br /> <br />Screening Method: <br />Verified Chain of Custody: 0 Yes 0No <br />SPOILS <br />Contamination Noted: El Yes El No <br />If yes, spoils storage Location: <br />Covered: 111 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: If' <br />Grout Material: /Veu, <br />Gallons of Grout Used: <br />DWell Installation El Well Destruction <br />111Boring Installation Ni'doring Destruction <br />METHOD USED <br />0Pressure Grout lilOver Drill <br />El Gravity Rtiremie 1110ther: <br />gall CtaV <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 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 />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank <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 />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />Feet <br /> <br />Screen Feet <br />‘'),7 <br /> /-51 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I 1 209 468-3420 I F 209 464-0138 I www.sicehd.com