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SAN4JOAQUIN Environmental Health Department <br /> I•' �t ' �`) —COUNTY— <br /> •"F�4"o��'r.. Greatness grows here. l 1 <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: `\ J .-1/31 kX Inspector: i �0� CONSTRUCTION <br /> to•�% � w �is .✓✓3 <br /> Facility Address: °l '1 nS . r+ of 2�� ca —,A-.e k <br /> Well Address: Total Depth: WAF <br /> WP# 60Mj017 Well#: GI S(w,7 Drilling Rig Type: _ <br /> Soil Boring#: CS r/ <br /> Min 2" Annular EHD Seal Verified: C�Yes ❑No <br /> Drilling Company: I�>nud '-rovtl <br /> Drilleronsite: ftyknay. Screen Length From: SArs To: S.SPt <br /> Consultant: Filter Pack From: '- To: <br /> : <br /> .ol H (�wyr Bentonite From: N •S�s To: <br /> Geologist: <br /> Grout From: O To,: ,Si z <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe &7 hristie Box <br /> Domestic Well Onsite: ❑ Yes ONO, casing <br /> If yes, location and distance: l # ne�gnt <br /> SAMPLING ABOVE-GROUND cHasrrBOX <br /> COMPLETION COMPLETION <br /> Holding Temperature: <br /> c-kour�d swrxo <br /> Method: <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> s = •- c <br /> If yes, spoils storage Location: slotted <br /> ascs°n <br /> Covered: El Yes ❑No _ -, 7, 164Pack <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: ._ <br /> Grout Material: Jll/ Co MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: y ya' 14 Casing Type: TAPlo <br /> L4Well Installation ❑ ell Destruction Blank Feet Screen ,r-s Feet <br /> Slot Size: <br /> ❑Boring Installation ❑Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Dover Drill Filter Pack Type/Size: <br /> N'Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 4711s Water Cement 9416 <br /> gall s Bags gall ons Bazs <br /> Thickest Thinnest VBags Thickest Thinnest 9Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 s 1 s m 1 113entonlie per 47 lb 1 1.411 2.47 _ <br /> 5 10' 2 10 jEhentonfite per 94lb 1 2.821 4.7 <br /> 7.5 Is 3 15 <br /> 10 20 4 20 40 9 (�G,, `7 I F ('uWs �- W( (p•..$�1W, <br /> 12.5 25 5 25 50 5 J b <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 B 40 80 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T' 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />