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=. SANJOAQUIN <br />—COUNTY— <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date:A-\1A 1/U1 Inspector: CONSTRUCTION <br />Facility Address: 1-11>\ t. <br />Well Address: Aj Total Depth: <br />WP# Well#: A446 Drilling Rig Type: <br />Soil Boring#: C a 11 , 1 L 1 , 1'4 Min 2" Annular EHD Seal Verified: <br />Drilling Company: Al r—nwi f. t& -O <br />❑ Yes ❑No <br />Driller Onsite: AW <br />Screen Length <br />From: <br />To: <br />-JL(, <br />Consultant: A2 Jq,5 ft7Nf:- e--Ah%l-( <br />Filter Pack <br />From: <br />To: <br />—�n <br />Geologist: f 6 L ,8/) <br />Bentonite <br />From: <br />To: <br />10 <br />Grout <br />From: <br />To: <br />Public Water System Onsite: ❑ Yes LINO <br />COMPLETION <br />❑ Stove Pipe <br />❑Christie Box <br />Domestic Well Onsite: [/Yes ❑No <br />If yes, location and distance: tiFiA-e-- <br />cnnnPI INr <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: ❑ Yes El No <br />SPOILS �� <br />Contamination Noted: El Yes 2No <br />If yes, spoils storage Location: <br />Covered: ElYes 1 <br />If yes, material: <br />GROUTING or DESTRUCTION Ttal Depth:_ <br />Depth to Water: <br />-Lw ) -5 , Z� I <br />Grout Material: <br />Gallons of Grout Used: 1!ti` 5QeIr <br />❑Well Installation ❑Well Destruction <br />El Boring Installation /Boring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />❑ Gravity COTremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />Water <br />Rallons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br /># s <br />Thickest Thinnest <br />#Bags <br />2.5 5 <br />5 <br />10 <br />1 <br />5 10 <br />2 <br />10 <br />20 <br />2 <br />7.5 15 <br />3 <br />15 <br />30 <br />3 <br />10 20 <br />4 <br />20 <br />40 <br />4 <br />12.5 25 <br />5 <br />25 <br />50 <br />5 <br />15 j 30 <br />6 <br />30 <br />60 <br />6 <br />17.5 1 35 <br />7 <br />35 <br />70 <br />7 <br />20 1 40 <br />8 <br />40 <br />80 <br />8 <br />tt. <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 />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />