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LII Boring Installation <br />METHOD USED <br />Boring Destruction <br /> <br />El Pressure Grout 00ver Drill <br />I tJ OTremie E Other: <br />COMPLETION El Stove Pipe Ii1Christie Box <br />Min 2" Annular EHD Seal Verified: 0 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />casing <br />height <br />CHRISTY-80X <br />ccmPuEnoN <br />ft <br />s <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />'''--- SAN JOAQUIN ‘,4 <br /> COUNTY <br />Environmental Health Department <br />Greatness grows het e <br />Monitoring Well/Soil <br />Date: '3 Inspector: <br />Facility Address: -776. SI Ay-ch J?_ <br />Well Address: <br />wp# 0U4 170 9 Well#: <br />Soil Boring#: yj <br />Drilling Drilling Company: W-64) 44+ /al rCv a- ph <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: El Yes 0No <br />Domestic Well Onsite: El Yes 0 No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes DI No <br />SPOILS <br />Contamination Noted: 0 Yes El No <br />If yes, spoils storage Location: <br />Covered: 0 Yes 171 No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 8 , S--0) /- <br />Depth to Water: /1/01,1,e,-- <br />Grout Material: /140-4- (01124,--+ <br />Gallons of Grout Used: -•• 10 <br />0Well Installation LI Well Destruction <br />c7r. 6,4 1-r14 - <br />g-a• ; I <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Water <br />gallons <br />cement 471b) <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest :nags Thickest Thinnest snags <br />2.5 s 1 5 10 <br />1- - <br />5 10 2 10 20 2 <br />7.5 15 3 15 30 3 <br />10 20 4 20 40 4 <br />12.5 25 5 25 50 5 <br />15 30 6 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 __ 40 80 8 <br />BentonitelCement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16/2017 <br />1868 E.JHazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com