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SAN JOAQUIN <br />COU NTY <br />Greatness groi“ here <br />En ironment rleaith Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 7-100 a Inspector: <br />Facility Addres : 9r f <br />Well Address: <br />WP# Well#: 4irt. <br />Soil Boring#: ttk, 67.-1 is otAgiscs- , cc..,, <br />Drilling Company: <br />Driller Onsite: d6c54, it letoof <br />Consultant: P4V+INCA,7 <br />Geologist: 19b NNAArbt,"" <br />CONSTRUCTION <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes EINo <br />To: <br />To: <br />To: <br />To: <br />From: <br />From: <br />From: <br />From: <br />Public Water System Onsite: <br />Domestic Well Onsite: <br />If yes, location and distance: <br />0 Yes 0No 0 Stove Pipe <br />casing <br />height <br />0Christie Box COMPLETION <br />0 Yes 111 No <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />COMPLETION <br />Verified Chain of Custody: <br />SPOILS <br />0 Yes ON° <br /> <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 313 <br />Grout Material: <br />Gallons of Grout Used: ciS) <br />0Well Installation 0.Well Destruction <br />El Boring Installation [ring Destruction <br />METHOD USED <br />GI Yes ENo <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Screen <br /> <br />Feet <br /> <br />Bags of Cement: <br />Bags Sand/Gravel: <br />(0)11)tO ) i.-3) Li; LS-, st- <br />Li Pressure Grout 00ver Drill <br />0 Gravity OTremie 00ther: <br />Water <br />gallons <br />Cement 47 lb <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest 4 Bags Thickest Thinnest 4 Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 <br />7,5 15 3 15 30 a <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 />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 />10/16/2 017 <br />1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 F 209 464-0138 I www.sicehd.com