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SAN )OAQUIN j Environments, Health Department <br /> L^ COUNTY <br /> �.'i'`rams"i Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 6-N-29 Inspector: p^6-e+- CONSTRUCTION <br /> Facility Address: lOU/ E• Ske.Etr May <br /> Well Address: Total Depth: <br /> WP#4-0?I Well#: Drilling Rig Type: <br /> Saw! BefiRg#f: 646-(4, a sc,4,Str3 <br /> Drilling Company: S/A lt Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller O / Screen Length From: To: <br /> Consultant: Spa S Filter Pack From: To: <br /> Geologist:�rte...- Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes El No casing <br /> If yes, location and distance: � height <br /> SAMPLING ABOVE-GROUND CHRkyaox <br /> Holding Temperature: oohlPtETbN DOMPLE ON <br /> Method: around S <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No n' <br /> n. <br /> SPOILS <br /> e <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: stoned 7 =_ 8 <br /> carton �''� <br /> Covered: ❑ Yes ❑No = Val pack <br /> If yes,material: <br /> GROUTING or DESTRUCTION Total Depth: S�7 <br /> DeP th to Water: 7-1 n' �n <br /> Grout Material: A4*4 a P^'t s MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation XWell Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout Ov Drill Type/Brand of Bentonite: <br /> � er s Filter Pack Type/Size: <br /> ❑ Gravity It.Tremie CROther: Type of Method: <br /> Water cement 471b Water Cement 941b <br /> M <br /> ns Ba s allonsThinnest NBags Thickest Thinnest aBags Bentonite/Cement MIX 3% MiX 5%MIX5 3 5 10 1 Bentonite er 47 Ib 1All 2.47 <br /> 10 2 10 20 2 Bentonite er 94 Ib 2.62 4.7 <br /> 15 3 15 30 320 4 20 40 4 <br /> 25 5 25 50 5 <br /> 30 6 30 60 6 <br /> 35 7 35 70 740 1 40 80 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 />