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SAN IUAUUIN <br />" <br />L- 4- —COUNTY— <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: it."14 <br />Inspector: A1A,5 Ea✓tk-t, <br />Facility Address: /// <br />S•e- <br />Well Address: <br />To: <br />WP# (003'310 D <br />Well#: <br />Soil Boring#: 131 <br />Grout <br />Drilling Company:,/{ <br />LA) <br />Driller Onsite: <br />5 <br />Consultant: wellgee- <br />le -0 d As ccck4S <br />Geologist: i).w. <br />10 <br />Public Water System Onsite <br />Domestic Well Onsite: <br />If yes, location and distance: <br />CANAPI INr, <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: Br h%00W 5few- 4v58r <br />Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br />Screen Length <br />From: <br />To: <br />Filter Pack <br />From: <br />To: <br />Bentonite <br />From: <br />To: <br />Grout <br />From: <br />To: <br />❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br />❑ Yes ❑ No <br />Verified Chain of Custody: ❑ Yes 11 No <br />SPOILS <br />Contamination Noted: ❑ Yes ❑No <br />If yes, spoils storage Location: <br />Covered: ❑ Yes El No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 0 1 <br />Depth to Water: 14 1 <br />Grout Material: _NLQ ca!r"tK� <br />Gallons of Grout Used: <br />❑Well Installation ❑Well Destruction <br />❑Boring Installation ))(Boring Destruction <br />MFTWnn 1ICFn <br />Pressure Grout ❑Over Drill <br />❑ Gravity KTremie ❑Other: <br />Water <br />gallons <br />Cement 471b <br />Bas <br />Water <br />gall ons <br />Cement 941b <br />Bags <br />Thickest Thinnest <br />uBags <br />Thickest Thinnest <br />4Bags <br />2.5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />7.5 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />12.5 <br />25 <br />5 <br />25 <br />so <br />5 <br />15 <br />30 <br />6 <br />30 <br />60 <br />6 <br />17.5 <br />35 <br />7 <br />35 <br />70 <br />7 <br />20 <br />40 <br />8 <br />1 40 <br />90 <br />8 <br />INNEEN-Mg� <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />ft. <br />Screen Feet <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 Ib 1.41 2.47 <br />Bentonite per 94 Ib 2.82 4.7 <br />//O <br />�p bu �!J t Or✓t w � 6a� <br />3o bet <br />vs�,( !/-c- o('s f� (3 �, /,3 2i /3 3,�'/ 10/16/2017 <br />//O /�a s <br />"1 0�ok[` '",Vs <br />186Hazelton AveueIStcton, Cao <br />rnia 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />