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--COUNTY--- <br /> Monitoring <br /> --MODit ' \A/e|k}SO'| Boring Inspection Report <br /> Facility Address: ,w,� <br /> Well Address: Total Depth:______ <br /> Vv Drilling Rig Type: <br /> Soil - Min 2" Annular EHDSeal Verified: 11 Yes ONo <br /> Screen Length From� To: <br /> Driller" �..,.`� <br /> Filter From: To: <br /> `"..^uu^ot: " `------ �__--_---- <br /> Geologist: Bentonite From: To:_________ <br /> ' Grout From: To:_________ <br /> Public VVaterSystem Onsite:� [] Yes []Wu <br /> {]}0PYJETl0N LJStove Pipe []Christie Box <br /> Domestic Well Onsite: [] Yes []No <br /> cns,�� <br /> |fyes, location and distance: e4��c <br /> S/AVRL0\kG x��m�� o `w«� k�- <br /> �0 <br /> o��/nr�azx <br /> Holding Temperature: ooupu�m* o�ype�om <br /> Method: oMjrmau��� <br /> Screening Method: grout/ <br /> Verified Chain ofCustody: [] Yes []No fl, <br /> I. <br /> SPOILS <br /> Contamination Noted: [] Yes []No a <br /> |fyes, spoils storage Location: | � <br /> cc <br /> Covered: [] Yes []No / <br /> |fyes, material: <br /> GROUTING or DESTRUCTION I Depth: <br /> D=p". `" ""a`=. ______ ___-�-~~~.�� ti. <br /> Grout Material: <br /> Gallons ofGrout Used: <br /> Casing Type: <br /> []VVe|| Installation []VVe|| Destruction Blank Feet Screen Feet <br /> r��o � <br /> []8oring|nsta||otion�ooringDestrucbSlot Size: <br /> Destruction <br /> Bags ofCement: <br /> METHOD USED BagsSand/Grave|: <br /> Type/BrandofBentonite�� <br /> []PreosureGrout []UverDri|| <br /> Filter Pack Type/Size: <br /> LV ravity []Tremie []Other: Type of Method: <br /> Rallons Baas '7a.1101-15 Bags <br /> I Th!) d BarktonitelCement Mix 3% Mix 5% Mix <br /> ic 2 10 20 2 Bentonite per 94 11) 2.82 4.7 <br /> � /�- . / ' c�,// <br /> � �/- '//)� ��� � ���� /`r^� ��//'^='~ <br /> � <br /> 17. <br /> � � <br /> �c�����^ <br /> 1O/l6/2017 <br /> 1868 E. Hazelton Avenue Stoukton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 <br />