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—COUNTY— <br /> _ , <br /> - __-- GTf.OYP.eS> Grens rete. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date: 1 L Inspector: J.� �N4e� CONSTRUCTION <br /> Facility Address: Le f a,•r,v, 1$m <br /> Well Address: Total Depth: <br /> WP# Qb-3 Kj ?e1 Well#: Drilling Rig Type: <br /> Soil Boring#: t>3. hq, �Z� Zm%01i tx p!3r3-)01V Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: V6 .o VI <br /> Screen Length From: To: <br /> Driller Onsite: <br /> Consultant: Filter Pack From: To: <br /> Geologist: Gs..$ <br /> 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 <br /> casing <br /> If yes, location and distance: height <br /> 4M <br /> SAMPLING AWVE-GROUND <br /> Holding Temperature: cc.h�,LETjoN rto <br /> Method: t3mUnd Sw-Fac2 <br /> Screening Method: yTD <br /> Verified Chain of Custody: ❑ Yes ❑Noy <br /> SPOILS "T <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: - <br /> zryour, <br /> Covered: ❑Yes ❑No 'w <br /> If yes, material: __ <br /> GROUTING or DESTRUCTION Total Depth:-S-P, 1S{(,�Zyf{s�11541� (sit, <br /> Depth to Water: ism= �5 J K�E6 - — — •. <br /> GroutMaterial: <br /> Gallons of Grout Used: MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation Is�oring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Dover Drill Filter Pack Type/Size: <br /> �avity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas lZall ons Baes <br /> Thickest Thinnest 4Bags Thickest Thinnest 7t Bags Bentonite/Cement Mix 3% Mix 5% Mix_ <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10, 2 10 20 2 Bentonite per 94 lb 2.62 4.7 <br /> 7,5 15 3 15 30 3 i <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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 468-34201 F 2D9 464-0138 1 www.slcehd.com <br />