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SANS 0A0UIN <br />+ <br />COUNTY— <br />Greatness growls Frere. <br />Environnientall Heali<.hi Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 01 IW f 2020 Inspector: K. Soea+er cN <br />Facility Address: 50p m. JOCK Tont 12 <br />Well Address: <br />WP#_ 0040444 Well#: <br />Soil Boring#: <br />Drilling Company: -Ter r -o con Ne. 10. Anderson 6'� <br />Driller Onsite: Rpber-+ AJ <br />Consultant:Tent-neon <br />Geologist: Ac4ron <br />Public Water System Onsite: <br />Domestic Well Onsite: <br />If yes, location and distance: <br />❑ Yes ❑No <br />❑ Yes ❑No <br />SAMPLING <br />Holding Temperature: <br />Cement 941b <br />Bags <br />Method: <br />kBags <br />Screening Method: <br />4Bags <br />Verified Chain of Custody: <br />❑ Yes ❑No <br />SPOILS <br />5 <br />Contamination Noted: <br />❑ Yes ❑No <br />If yes, spoils storage Location: <br />18 <br />Covered: <br />❑ Yes ❑No <br />If yes, material: <br />2 <br />GROUTING or DESTRUCTION Totai Depth: 15t 4) <br />Depth to Water: Nate <br />Grout Material: Nem+ Cemenl - <br />Gallons of Grout Used: F)6.1!5 <br />❑Well Installation ❑Well Destruction <br />El Boring Installation l)(Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity 14Tremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />kBags <br />Thickest Thinnest <br />4Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />18 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />1 30 <br />3 <br />10 <br />20 <br />4 <br />28 <br />40 <br />4 <br />1715 <br />25 <br />5 <br />25 <br />50 <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />40 <br />80 <br />8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: 6 <br />Min 2" Annular EHD Seal VeNfied: <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />COMPLETION ❑ Stove Pipe <br />❑ Yes ❑No <br />To: <br />To: <br />To: <br />To: <br />❑Christie Box <br />casing <br />height <br />ABOVE -GROUND <br />c owLE ION c ssrr-aox <br />comp=ON <br />C3ra9rzi sulks <br />tt. <br />M � O <br />- o <br />sloUd :- <br />tacdan <br />". <br />c�,na,t lack <br />—ft <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />Screen Feet <br />BentoniteXemenf Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2A7 <br />Bentonite per 94 Iia 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sicehd.com <br />I <br />