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SAN JOAQUIN Environmental Health Department <br /> " COUNTY -- <br /> ���, P Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: Inspector: ST-01 FWJO CONSTRUCTION <br /> Facility Address: i1t00 P0tftOf StGCK-br? <br /> Well Address: Total Depth: <br /> WP#C70 q IZQ^ Well#: Drilling Rig Type: <br /> Soil Boring#: C!"'T- t , ct r Iq ; b` 5 <br /> Drilling Company: �U-1X SVf�Sti'f fqT E1fpK��U00r) Min 2"Annular EHD Seal Verified: El Yes El No <br /> Driller Onsite: F'14 , C011-103: Screen Length From: To: <br /> Consultant: GUt�I�Qtf- pI.�1Y;inC� Filter Pack From: To: <br /> Geologist: MGrCO ,-CCCr" <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETICN COMPLETION <br /> Method: Ground Sumacs <br /> Screening Method: Ft grout <br /> Verified Chain of Custody: ❑ Yes El No �tt' <br /> n. <br /> ts. <br /> SPOILS = <br /> = a <br /> Contamination Noted: ❑ Yes ❑No — <br /> If yes,spoils storage Location: .torte <br /> ascdon — B <br /> Covered: ❑ Yes ❑No = t <br /> If yes, material: '< <br /> GROUTING or DESTRUCTION Total Depth: 3`KI <br /> Depth to Water: 11 ' n• n <br /> Grout Material: WQQ't Cc'WW t MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 13�3' <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑ Slot Size: <br /> Boring Installation Aoring Destruction Bags Size: <br /> Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size: <br /> ❑ Gravity gTremie ❑Other: Type of Method: <br /> water Cement 471b Water Cement 941b <br /> 111 gallons Bas eall1l ons Bags <br /> Thigest Thinnest 4Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 UPT 10 <br /> 12.5 25 5 25 50 5 C `I`� (;`h <br /> 15 30 6 30 60 6 1,4 tfi IbS 0Qtr2M P, jb& CQf'qpt to X Q`1 IY3 cenvjq <br /> 17.5 35 7 35 70 7 12 gg11rjntNgt42r t3 1;�tl�i15 WYQ�Q� 5U ganrnS vf4lot� <br /> 20 40 8 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 />