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SAN JOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Greatness grows here. (° <br /> Monitoring Well/Soil Boring Inspection Report 4, <br /> Date: I, 24 Inspector: X,_fhAMMaV CONSTRUCTION <br /> Facility Address: tN S kffl U00A,Well Address: MQIAVICd14i %g Total Depth: oiw"'6I o a <br /> WP# ��kOmZ?�t Well#: t (bl=]�12 Drilling Rig Type: ll <br /> Soil Boring#: <br /> Drilling Company: (anto�o/�I Min 2"Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: (�7t%kk--- Screen Length From: To: <br /> Consultant: (A&lIL,tlia DWR Filter Pack From: To: <br /> Geologist: bYI ALPj Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑Yes []No casing <br /> If yes, location and distance: � height <br /> —CWT <br /> SAMPLING AJ30VE•GRCUND <br /> cowLErION compLeAOx <br /> Holding Temperature: coMpLErioN <br /> Method: Groundsudaco 7— <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes []No ft. <br /> rt. <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes,spoils storage Location: abmd yj <br /> Covered: ❑ Yes ❑No sac-on _ $ <br /> g"Val pads <br /> If yes, material: <br /> 1 � <br /> GROUTING or DESTRUCTION Total Depth:_ <br /> Depth to Water: ft• — n• <br /> Grout Material: eirny)-f <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> 214 02,mA Casing Type: <br /> Aell Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation El Boring Destruction <br /> 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 Xemie ❑Other: Type of Method: <br /> Water Cement471b Water Cement 991b 'I <br /> allons Bags gallons Baas <br /> Thickest Thinnest RBags Thickest Thinnest OBggs lBeEntonite <br /> ntonite/Cement MIX Sa/a Mix 5a/a MIX <br /> 2.s s 1 s 10 1 le per 47 lb 1.41 2.47 <br /> s 10 2 10 20 2 per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 3o 3 <br /> 10 20 4 20 40 4 '�', �,1.� ',I r I� yyy���,/,, p`rs '^ <br /> 12.5 25 5 25 50 5 NV Vs1� wol 01 ''� P e AKA' t <br /> 15 30 6 30 60 6 //��^,, r�11^ /�.� 1 <br /> 17.5 35 7 35 70 7 -fbp johi-Ira U Seal • e'e <br /> 20 40 B 40 BB B tin J rypYra v V <br /> 10 IDa {(}� 1 V �/ �� pal Wow 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 />