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SAN�JOAQUIN <br /> Environmental Health Department <br /> \ L•1I',::: � —COUNTY— <br /> r rT <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 3/(,/tu Inspector: IK LI- CONSTRUCTION <br /> Facility Address: %4 Lot 6. Cc&"5tc/6 -txA t <br /> Well Address: Total Depth: ✓_ O <br /> WP#o/4ci Zq0 Well#: M(%/l Drilling Rig Type: p i m 1-1 <br /> Soil Boring#: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company:_ GVI I uu,.0 C ftch.lx�f 5e-W'.1 <br /> Driller Onsite: A wtaclnr Screen Length From: 80 To: 66 <br /> Consultant: Filter Pack54mA From: %G TO: 56 <br /> Geologist: 17'ce tr"uSC.A. Bentonite From: To: 56 <br /> Grout From: 5 6 To: Nr a <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe Whristie Box <br /> Domestic Well Onsite: ❑ Yes ❑No —� cato Ln9 <br /> If yes, location and distance: j f hel9ht <br /> SAMPLING ABOVE•CinCUNo <br /> CO&FLErION COMPLETION <br /> Holding Temperature: cadrtFnoN <br /> Method: emend nd sunacs T <br /> Screening Method: groat <br /> Verified Chain of Custody: ❑ Yes ❑No �ft. <br /> _n. <br /> n. <br /> SPOILS <br /> Contamination Noted: Yes ❑No <br /> If yes,spoils storage Location: Sbq1 rAw4weitST' <br /> tl°Iiad <br /> aty B <br /> Covered: ply 91' t an❑ Yes ❑Not _ grav,4 <br /> If yes, material: �! <br /> GROUTING or DESTRUCTION Total Depth: �Gt = •. <br /> Depth to Water: 70% <br /> Grout Material: VAcoj' Cemehr <br /> Gallons of Grout Used: 241 grw1 MATERIALS DEVELOPMENT <br /> Casing Type: 2 V G <br /> Well Installation ❑Well Destruction Blank 60 Feet Screen ZO Feet <br /> Slot Size: 071 <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: 3 <br /> G loci <br /> METHOD USED Bags Sand/Gravel: IS Lj G Sa.atA. <br /> Type/Brand of Bentonite: CC 6fi rvlwliuuachiBS <br /> ❑Pressure Grout ❑Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity KTremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bags stations Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% MIx 5% MIX <br /> 2s 5 1 5 10 1 Bentonite per 47 lb 1 1.41 2.47 <br /> 10 2 10 20 2 Bentonite per 94 lb 2.821 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 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 40 BO 0 <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 />