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SAN JOAQUIN Environmental Health Department <br /> —COUNTY <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: ('L 4 Inspector: Y�. L.-ems_ CONSTRUCTION <br /> Facility Address: Zc0' 51Fl Asct4 ILt4 <br /> Well Address: Total Depth: <br /> WP# Z40016y Well#: Drilling Rig Type: <br /> Soil Boring#: (s ta/$ irl11af d, V49 5C-Wp1e Min 2"Annular EHD Seal Verified: ❑ Yes ONO <br /> Drilling Company: Qrnne c�a.e <br /> Driller Onsite: Jo✓ci a Screen Length From: To: <br /> Consultant: PN✓icw Filter Pack From: To: <br /> Geologist: A-Lct v1 ystAe4- Bentonite From: To: <br /> Grout From: To: <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: f height <br /> SAMPLING ABOVE-GROUND <br /> t�&FLErION crwtsiEmON <br /> Holding Temperature: con4PlErtoN <br /> Method: <br /> Screening Method: gran <br /> Verified Chain of Custody: ❑ Yes ❑No ft. <br /> ft. <br /> SPOILS - <br /> - o <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: abllad <br /> section — 3 <br /> Covered: ❑ Yes ❑No ft = <br /> '. Qnvat pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:5-3.S+G01 <br /> Depth to Water: "39I.51 <br /> Grout Material: "CaJ cv,—CU <br /> Gallons of Grout Used: 2S 6cop �ut MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation rKnoring 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 /> ❑ Gravity 4Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags eallons Bees <br /> Thickest Thinnest NBags Thickest Thinnest PBags Bentonite/Cement Mix 3% Mix 5%Mix <br /> 2.5 5 1 5 10 1 1 Bentonite per 47 lb 1.411 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.821 4.7 <br /> 7.5 15 3 15 30 3 - tom, <br /> 1. 20 4 20 40 4 51�PN 1 A p slryl�i s' 40 q vr,4) L I rt4CM/'s P. <br /> 11.5 25 5 15 50 5 iJ /^�� ✓ <br /> 15 30 6 30 60 6 phalLS �, t tiz 5L,pp Lif.i �4 qel° _Oi(JI <br /> 17.5 35 7 35 70 7 ,-1. ✓ ✓ Lv <br /> 20 40 a 40 eo s 4lu j % ,t,L <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 /> t <br />