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.. ... .. . .- <br /> . .L -I- <br /> `' — <br /> COUNTY-Greatness groes here. <br /> Moni'L-, ing Well/Soil Boring Inspectio.. ,ieport <br /> Date: t It Inspector: t--✓ ►a_-"� CONSTRUCTION <br /> Facility Address: 1lv?77 E-i,rSLdL9,1 <br /> Well Address: 7,07 fit. Total Depth: <br /> WP# C7p 11 tot' Well#: Drilling Rig Type: <br /> Soil Boring#: <br /> So <br /> Drilling Company: Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: � � � Filter Pack From: To: <br /> Geologist: <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 =sing <br /> If yes, location and distance: height <br /> TV _Vw -_ <br /> SAMPLING ABOVE-6ROUN 3 CHR - <br /> Holding Temperature: co.WLEnoN c � orxa <br /> Method: <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑No fL <br /> ft. <br /> #t <br /> SPOILS = <br /> Contamination Noted: ❑ Yes ❑No - — <br /> If yes, spoils storage Location: <br /> Covered: ❑Yes ❑No w = <br /> If yes, material: = Wt <br /> GROUTING or DESTRUCTION Total Qepth: Zk1 <br /> Depth to Water: - IF <br /> n' <br /> Grout Material: <br /> Gallons of Grout Used: S MATERIALS/DEVELOPMENT <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <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 Zt Tlemie ❑Other: Type of Method: <br /> )Nater Cement 471b Water Cement 94Ib <br /> gallons Bas gall ons Bails <br /> Thickest Thinnest J:Bags Thickest Thinnest #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 Ib 2.82 4. <br /> 7.5 15 3 15 30 3 <br /> 1205 25 5 25 50 5 —�� P ! 6� �b ��✓gyp„� <br /> 15 30 6 30 6o 6 <br /> 17.5 35 7 35 70 7 / l /� 16 �1 <br /> 20 40 8 40 80 8 C i� p <br /> �- �I� I --60/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T' 209 468-34201 F 209 464-0138 I www.slcehd.com <br />