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i, SANSJOAQUIN <br /> COUNTv Environmental Health Department <br /> Greotness grows here. t <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 5112123 Inspector: CONSTRUCTION <br /> Facility Address: <br /> Well Address: Total Depth:6 <br /> 11 <br /> WP# WP7�A001b3 Well#: Drilling Rig Type: 6 <br /> Soil Boring#: K W -d1 <br /> Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: �I�lly-p t 361 <br /> Screen Length From: To: <br /> Driller Onsite: Filter Pack From: To: 1,Yj <br /> Consultant: Lain 5 <br /> Geologist (G�VI Bentonite From:— S To: <br /> Grout From: 2,b To: 71 <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: � height <br /> SAMPLING ABCVEEGRCUND CNRISIY-BOX <br /> Holding Temperature: ooMPLEMN COMPLETION <br /> Method: G=nasurac. -- <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑No —tt <br /> tt. <br /> SPOILS k <br /> _ e '15 bP,vt-foul iFe <br /> Contamination Noted: ❑Yes ❑No ° 3�i <br /> j o <br /> If yes,spoils storage Location: •b� ,,;: _ 8 `/ �/ <br /> Covered: ❑ Yes ❑No <br /> g- Pack <br /> If yes, material: __ <br /> /19n I( ZU_Z 11 <br /> GROUTING or DESTRUCTION Total Depth:_._ 60_�__ I <br /> — <br /> Depth to Water: • tt. tt. <br /> Grout Material: K (10, 1 MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: ^L 11 11 Casing Type: <br /> *ell Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction <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 /> ❑ Gravity NTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons BaRs ealions Ba s <br /> Thkkest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement MIX 3% Mix 5%Mix <br /> 2.5 5 1 1 5 10 1 Bentonite per 47 lb 1 1.41 2.47 <br /> 5 io 2 10 20 2 Bentonite per 94lb 2.82 4.7 <br /> ES 15 3 15 30 3 <br /> 30 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 V 30 60 6 <br /> 17.5 35 7 1 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 209 468-34201 F 209 464-0138 1 www.svicehd.com <br />