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SANJOA UIN <br /> Q Environme,r.al Wealth Department <br /> rLd —COUNTY— <br /> c«wo;aP Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 7-/0-1Q Inspector: /Plh&*n CONSTRUCTION <br /> Facility Address: 1-36 4-e <br /> Well Address: Total Depth: <br /> WP# 00M796 Well#: Drilling Rig Type: <br /> Soil Boring#: f p /d' <br /> Drilling Company: Cascgk Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: r Screen Length From: To: <br /> Consultant: /r} 4 Filter Pack From: To: <br /> Geologist:Tiafr <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes ❑NO casing <br /> If yes,location and distance: height <br /> SAMPLING ABOVE-GROUND CHRM-TY-BOX <br /> Holding Temperature: c-oNPLET1oN compt.E ioN <br /> Method: Ground Suiaea 7 <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No tt' <br /> tt. <br /> _n. <br /> SPOILS o <br /> _ } a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: aloes <br /> m don <br /> Covered: ❑ Yes ONO <br /> graval pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: Z7 n. tt• <br /> Grout Material: AMN L e"#1 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation g Destruction Slot Size: <br /> C�Borin Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Dover Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity Vrremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags alions Ba s _ <br /> Thickest Thinnest #Bags Thickest Thinnest Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> z5 5 1 5 10 1 Bentonite er47lb 1.41 2.47 <br /> 5 10 2 10 20 z Bentonite per 94lb 2.82 4.71. <br /> 15 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 0 40 00 B <br /> w1,4 W5� IV' 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 />