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SAK JOAQUIN <br /> Environmental Health Department <br /> Greatness grows here. oo+et 12W 2,7 tool <br /> Monitoring Well/Soil Boring Inspection Report doh af�111S <br /> Date: G120123pecto�� I CONSTRUCTION <br /> Facility Address: SWV0 , <br /> Well Address: Total Depth: 6 I 1 - <br /> WP# i2W 25 ei##:� � � Drilling RigTYp, KtJ(A �dIUYL� <br /> Soil Boring#: <br /> Drilling Company: Min 2"Annular EHD Seal Verified: 17 Yes ❑No <br /> Driller Onsite: Screen Length From: \(oI To: °5'S <br /> Consultant: when Filter Pack From: t!2 To: 55 <br /> Geologist: J(k$t)n Bentonite From:_ To:�b <br /> Grout From: 1q To: 0 <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes []No casing <br /> If yes,location and distance: � height <br /> SAMPLING �po <br /> COMPLETION CHRIS7Y-90X <br /> Holding Temperature: rOXLya ON <br /> Method: Ground S`°f°" <br /> Screening Method: grout '�1 <br /> Verified Chain of Custody: ❑Yes ❑No <br /> !�.$. <br /> SPOILS <br /> Contamination Noted: ❑Yes ❑No <br /> If yes spoils storage Location: <br /> �btan <br /> NrJo r <br /> Covered: ❑Yes ❑No d <br /> 9-Vo Pack <br /> If yes, material: <br /> GROUTING or-DESTRUCTION-Total Depth:— `.'-_1Sl <br /> Depth to Water: `(� hCbr "JS+ ft. 7 g• <br /> Grout Material: MATERIALS/DEVELOPMENT 90) <br /> Gallons of Grout Used: Casing Type: Gbvrt SnaoX <br /> L Nell Installation ❑Well Destruction Blank O—ZO Feet66�Screen 2G_Sd Feet �� <br /> ❑Boring Installation ❑Boring Destruction Slot Size: m UQkE <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: L 6 O#S Q <br /> ❑Pressure Grout []Over Drill Type/Brand of Bentonite: G �(-* <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: Q i�SSUt Q rn} , <br /> t <br /> Water Cement 471b Water Cement 941b <br /> M <br /> ns 0a s allons Ba sThinnest 0 Bags Thickest Thinnest sB BentoniteXement Mix 3% Mix 5% Mix5 1 5 10 1 Bentonite per47lb 1.41 10 2 10 20 z1 lBentonite per 94 lb 1 2.82 4.7 <br /> 7.5 35 3 15 30 3 I I i i <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 1 40 180 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 />