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SAN JOAQUIN <br />-- COUNTY <br />• <br />Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil <br />Date:2.312A Inspector: 5C\A j <br />Facility A dress: 0 filkA5R St15106 givtr <br />Well Address: <br />WP# 0 CM1(0 II Well#: 645. <br />Soil Boring#: AAN2, (Ap5A4 +0 -1-44, 549,65tau5 <br />Drilling Company: cheo-x <br />Driller Onsite: Jc6e, <br />Consultant: v.te,jv4ed <br />Geologist: P6oc) <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes 111No <br />To: <br />To: <br />To: <br />To: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout From: <br />Public Water System Onsite: 0 Yes EN° COMPLETION CI Stove Pipe El Christie Box <br /> <br />Domestic Well Onsite: 0 Yes L1No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes 0No <br />SPOILS <br />Contamination Noted: 0 Yes EINo <br />If yes, spoils storage Location: <br />Covered: CI Yes EN° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: i5bc r. <br />Grout Material: <br />Depth to Water: <br />inetv- egivg4+- (8 <br />Gallons of Grout Used: /\., cc() a <br />111Well Installation El Well Destruction <br />Boring Installation OBoring Destruction llbacS5 <br />METHOD USED <br />KPressure Grout 1110ver Drill <br />LI Gravity 111Tremie 1110ther <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest 4Bags Thickest Thinnest bags <br />2,5 5 1 s 10 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 />casing <br />height <br />Ground Surfao• <br />_ft. <br />slotted <br />ssodon <br />Jr <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 />Bentonite/Cement 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 />tt <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com