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S A NJ 0 A Q U I N <br /> COUNTY <br /> Greutness rows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: lfj'31nspector: CONSTRUCTION <br /> Facility Address: O c_ <br /> Well Address: v, Total Depth: �b <br /> WP# \ A Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: � Min 2" Annular EHD Seal Verified: C�] Yes CINo <br /> Driller Onsite: Screen Length From: To: b <br /> Consultant: '�"� � 5 Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: o: <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: hsight <br /> i <br /> SAMPLING ABC -GRCU D <br /> Holding Temperature: L'OWLETION C��oN <br /> Method: Gmdryd suta= <br /> Screening Method: ate <br /> Verified Chain of Custody: ❑ Yes ❑Noa <br /> �. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> a <br /> If yes, spoils storage Location: 3 <br /> Flo � 2 <br /> Covered: ❑ Yes ❑No <br /> Pack <br /> If yes, material: -� <br /> ROUTING or DESTRUCTION Total Depth:�� <br /> ZO <br /> Grout Material: k-y�-N MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: a4lCasing Type:T e: �� L, <br /> ❑Well Installation ❑Well Destruction Blank bS Feet Screen 151 Feet <br /> , <br /> ❑Boring Installation ❑ Slot Size: :;ice &, tn' 'vBoring 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 /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water cement 471b Water Cement 941b <br /> allons Bags all Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags BentonitE3Xement Mix 3% Mix 5% Mix <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 1s 3 15 30 3 t <br /> 10 20 4 20 40 4 <br /> 12,5 25 5 25 50 5 <br /> 15 80 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 2D 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 />