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-� 3A114JuAVu114 Environmental Health Department <br /> —COUNTY- <br /> -_ _ <br /> Greotne>s Grows „ere. <br /> Monl,,ring Well/Soil Boring Inspection Report <br /> Date: 1 I-7 l Inspector: Lew CONSTRUCTION <br /> Facility Address: 16-7-7-7 <br /> Well Address: 1 k c_,% Total Depth: 'Z,&3_ <br /> WP# 003" j ) We I#:. —(n Drilling Rig Type: rv%• n4" <br /> Soil Boring#: <br /> Min 2"Annular EHD Seal Verified: ITXes ❑No <br /> Drilling Company: Y.Tto,,.' j &yK o f <br /> Driller Onsite: R,."a � e•••.�d� <br /> Screen Length From: To: <br /> Consultant: GeoS.4►vtu, <br /> Filter Pack From: ;, To: ?�3 <br /> —� Bentonite From: To: vs3 <br /> Geologist: '�,a..� <br /> Grout From: 0 To: "Y <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION L✓1, Stove Pipe ❑Christi Box <br /> Domestic Well Onsite: ❑ Yes ❑No P"- -` "S"`X <br /> casing ' <br /> If yes, location and distance: his1ght <br /> SAMPLING • <br /> Holding Temperature: 00.WLErION GOWLETioN <br /> Method: G"nd Su laca <br /> Screening Method: arm <br /> Verified Chain of Custody: ❑ Yes ❑No 2 g rL <br /> SPOILS <br /> Contamination Noted: ❑ Yes ❑No K. — <br /> If yes, spoils storage Location: <br /> Z10r,2d _— <br /> Covered: ❑Yes ❑No _ <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth:_'L�� — <br /> Depth to Water: ®w — <br /> Grout Material: t\t* MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: g yp . <br /> --W// Casin T e: �s ,S-1'.eQ,l <br /> L< ell Installation ❑Well Destruction Blank Zs-& Feet Screen �' Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: '�Zo <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grou;�r <br /> ❑Ov r Drill <br /> Filter Pack Type/Size:�T12 <br /> ❑ Gravity emie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gal Ions Bas gallons Bags <br /> Thickest Thinnest 4Bags Thickest Thinnest 1J Bags BentonitefCement Mix 3% Mix 5% Mix <br /> 2.5 5 1 s 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10' 2 10 20 2 Bentonite per 941b 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 A 20 40 4 <br /> I 1 i I <br /> 12.5 25 s zs so <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 209 464-0138 1 www.sicehd.com <br />