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SAN JOAQUIN Environmental Health Department <br /> COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: CIIZI'25 Inspector: CONSTRUCTION <br /> Facility Address: 215%A S. Dur,_6ko !S+. I <br /> Well Address: Total Depth: 126 `,G You+ 5(A <br /> WP# 2,5Wb q6 Well#: Hui I_N Drilling Rig Type: g <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: 1 Yes El No <br /> Drilling Company: �,LS <br /> Driller Onsite: Screen Length From: 12 �� To: (O <br /> Consultant: ( C Ui J-aLl, Filter Pack From: it b To: <br /> Geologist: ;; Bentonite From: bf:J To: d� <br /> Grout From: I p6 To:_;� <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe XChristie Box <br /> Domestic Well Onsite: ❑ Yes ❑No \J(,t V� (�OCA�i t1 y <br /> casing <br /> If yes, location and distance: height Ova }�fQ <br /> _qWT <br /> SAMPLING ABOVE-GROUND <br /> IS`TY <br /> Holding Temperature: COWLEr10N COMPLET C14 <br /> Method: G=nd Surface <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No -�—n- <br /> ft. <br /> ft. <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No = <br /> If yes, spoils storage Location: <br /> stortvd _ <br /> sar.on <br /> Covered: ❑ Yes ❑No <br /> 9 WPock <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: k2G; _ <br /> Depth to Water: n• L— tt- <br /> Grout Material: - <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: 6ia),lI- CaS+ <br /> Well Installation ❑Well Destruction Blank lib Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: a ) <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: i� <br /> ❑Pressure Grout ❑Over Drill Type/Brand of Bentonite: �� <br /> Filter Pack Type/Size: T-i {Qg f2atA,, <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: nAIQ1) <br /> Water men,171b Water Cement 941b <br /> allons Ba s allons Bags <br /> Thickest Thinnest t! Thickest Thinnest bBags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10 z 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6119 30 60 6 <br /> 17.5 35 35 70 7 <br /> 20 40 8 40 80 8 <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 />