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°I. SANJOAQUIN <br /> + —COUNTY— Environmental ;lealth Department <br /> tytiF°a"% Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 7-18't'I Inspector: N156-� CONSTRUCTION <br /> Facility Address: Zq AAA <br /> Well Address: Total Depth: <br /> WP#60 977,10 Well#: Drilling Rig Type: <br /> Soil Boring#: / Ale yip/02� ,cjpla �2 ae <br /> Drilling Company: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: bile p Screen Length From: To: <br /> Consultant: /5 —A/ n,-A' Filter Pack From: To: <br /> Geologist: G/uY...,� u� „1.. Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ONO COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No <br /> casing <br /> If yes, location and distance: height <br /> SAMPLING <br /> ABOVE-GROUND <br /> cowt. CF-swiY-BOX <br /> Holding Temperature: � �TbN COMPLEmON <br /> Method: / Ground surl < �— <br /> Screening Method: �e/11fP/�L� Y , EoZo grout <br /> Verified Chain of Custody: ❑ Yes ONO <br /> SPOILS —h' — ft <br /> Contamination Noted: ❑ Yes ONO t = <br /> If yes,spoils storage Location: .lobed <br /> Covered: ❑ Yes ONO <br /> a° .on = S <br /> If yes, material: c <br /> any Pack <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: 30 <br /> Grout Material: ,✓!sr �'e <br /> Gallons of Grout Used: 1bJ, i63 q1� b MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> []Boring Installation 0?Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> ( Filter Pack Type/Size: <br /> El Gravity VTremie Other: /,seem V 7 S Type of Method: <br /> Water cement 471b Wa[er Cement 941b <br /> allons Ba s eallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags _ Bentonite/Cement MIX 3%MIX 5% MIX <br /> 2.5 5 1 s 10 1 Bentonite per 47 lb 1.41 ', - <br /> 5 10 2 10 20 2 Bentonite per 94lb 1 2.82 4.7 7.5 1s 3 15 30 3 - <br /> 30 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 1 30 6 30 60 6 <br /> 17.5 1 35 7 35 70 7 <br /> 10 40 B 40 BO B <br /> 10/16/2017 <br /> 1 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.corn <br />