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SAN, JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: AP""yn- Inspector: .411—e-0 CONSTRUCTION <br /> Facility Address: F�� t <br /> Well Address: Total Depth: 7y <br /> WP#�til Well#: Mw8 Drilling Rig Type: � <br /> Soil Boring#: — Min 2"Annular EHD Seal Verified: C3'Yes ❑No <br /> Drilling Company: ease 4Screen Length From: ?d' To: Sit <br /> Driller Onsite: 2>4 -ie Ms��•. Filter Pack From: 1J To: <br /> Consultant: �7� 'r Bentonite From: 1/4S t To: 46a d fY+ Y <br /> Geologist: eryti <br /> Grout From: LIV To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe 015hristie Box k� <br /> Domestic Well Onsite: ❑Yes ❑No casing - d <br /> -- ��If yes,location and distance: height T <br /> SAMPLING ABOVEGROUND CHRl.M430X T <br /> COMPLETION OOMPLETION <br /> Holding Temperature: Winds tK, <br /> Method: <br /> grout <br /> Screening Method: <br /> tt. <br /> Verified Chain of Custody: ❑ Yes ❑No tt. <br /> SPOILS <br /> 76 a <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: .lurtad s's = $ <br /> sac on <br /> Covered: ❑Yes ❑No = gnva pacx <br /> If yes, material: c r _ <br /> GROUTING or DESTRUCTION Total Depth: 76 n <br /> Depth to Water: 1Y tt. <br /> Grout Material:jry ce".✓t MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: iso�� Casing Type: Jc G <br /> CSWellInstallation ❑Well Destruction Blanker set Screen �' Feet <br /> Slot Size: 01 0 <br /> El Boring Installation El Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: S( 6L-jt'-S <br /> Type/Brand of Bentonite: C­fs 3 9" <br /> ❑Pressure Grout ❑Over Drill Filter Pack Type/Size:_ is <br /> ❑ Gravity <br /> remie ❑Other: Type of Method: <br /> ate Ce t47 Water cement 941b <br /> all allons Ba s Thickest Thinnest #sags Thickest Thinnest Mlis Bentonite/Cement MIX 3%MIX 5"a MIX <br /> 25 5 1 5 10 1 Bentonite er47110 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 ID 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 /� ,err <br /> 12.5 25 5 25 so 5 ✓ <br /> �, ee� f,'1-" <br /> 15 30 6 30 60 /� �[ <br /> 17.5 35 7 35 70 7 3 y DiL I/7T '10 <br />-- 20 40 ed 40 60 0 O /�' /((// %,t' 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 />