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SA610AQUIN <br /> Environmental Health Department <br /> • �".z�r��:� —COUNTY— P <br /> H *��J Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 11/Ui Inspector: aJfe&�!j CONSTRUCTION <br /> Facility Address: Sctuu S. .4rNPorF w, <br /> Well Address: Total Depth: <br /> WP# Well#: Drilling Rig Type: <br /> Soil Boring#: 9j-LJ <br /> Min 2"Annular EHD Seal Verified: ❑Yes ❑No <br /> Drilling Company: vrrlL& <br /> Driller Onsite: m t Screen Length From: To: <br /> Consultant: Filter Pack From: To: <br /> Geologist; ✓f H�. Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: Cl Yes ❑No COMPLETION ❑ Stove Pipe QChrfstfe Box <br /> Domestic Well Onsite: ❑Yes []No Qasa3 <br /> If yes,location and distance: hei4ht •' <br /> SAMPLING A18, Q <br /> COMPLETION cxi3lsL eox <br /> Holding Temperature: coMet�TTofl <br /> Method: ac«i asuiaca -- ..—. <br /> Screening Method: gran <br /> Verified Chain of Custody: ❑Yes ❑Ncs <br /> ft. <br /> SPOILS <br /> Contamination Noted: ❑Yes ❑No <br /> r <br /> Ifyes,spoils storage Location: ato <br /> Covered: El Yes ❑No wl,n <br /> waim Pack <br /> If yes,material: RE <br /> GROUTING-or-DESTRUCTION.Total Depth:--7.�•�-..• <br /> Depth to Water: /V/A• � �• <br /> Grout Material:V ecJ Cew a't L✓/ $�burl n MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Gaul . Casing Type: <br /> ❑Well Installation OWell Destruction Blank Feet Screen Feet <br /> ❑Boring Installation B Slot Size:aring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> []Pressure Grout []Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> Ef Gravity ClTremie Bother: Type of Method: <br /> Water Cement 471b Water Cement041b <br /> gallons Ba s allone sa <br /> Thickest Thinnest a Bogs Thickest Thinnest Hags Bentonite/Cement Mix 3% Mix 8%Mix <br /> 215 5 1 s i0 1 Bentonfte per 47 lb 1.41 2 41 <br /> s 10 2 10 20 2 13entonfte per 94lb 2.82 4.7 <br /> 7.5 15 0 15 00 5 <br /> 10 a 4 20' 40 4 <br /> 115 25 5 25 50 5 <br /> 15 30 6 so 60 6 <br /> 17.5 as 7 25 70 7 <br /> 20 40 0 AO e0 6 <br /> 6"L 1oa� 5 tt5 &H 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138.1 www.sicehd.com <br />