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r? ; tmironmemaii Mditfl UIYIJd1 L'Pnem <br /> —COUNTY <br /> Grecrtness <br /> COUNTYGreatness Grams dere. <br /> Moni-Luring Well/Soil Boring lnspectio„ report <br /> Date: I-0 it Inspector: (fir )�' CONSTRUCTION <br /> Facility Address: 1(,77'1 4-if.. Z <br /> Well Address: Total Depth: �� 3 <br /> WP# ool� `ki2 Well#: A�_3 Drilling Rig Type: <br /> Soil Boring#: <br /> r�,�.J ;]�•.-1R�� �V►_� Min 2"Annular EHD Seal Verified: ❑ es ONO <br /> Drilling Company: Y <br /> Driller Onsite: ria,,., Screen Length From: '?�sJ To: :Z_.,q* <br /> Consultant: Gco4-..mac. <br /> Filter Pack From: To: f2 -y� <br /> Geologist: �„�,,,... Bentonite From:�� To: ZIs3 <br /> Grout From: O To:_� <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION F,� Ove Pipe ❑Christie Box <br /> Domestic Well Onsite: El Yes []Nof'41V_ <br /> casing <br /> If yes, location and distance: Yieig3it <br /> SAMPLING ABOVE-GRCUNi o <br /> Holding Temperature: CChP�F°H COMP`oN <br /> Method: °ta" <br /> Screening Method: Qfcut <br /> Verified Chain of Custody: ❑ Yes ❑Noy <br /> it. <br /> SPOILS <br /> j <br /> Contamination Noted: ❑Yes ❑No <br /> If yes, spoils storage Location: t — E <br /> Covered: ❑Yes ❑No <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: �.,,,,,.,ts�..a.,.� tt . F JL <br /> Grout Material: Aer Ct� MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: Casing Type: <br /> ell Installation ❑Well Destruction Blank 't-110� Feet Screen S' Feet <br /> Z, <br /> ❑Boring Installation El Boring Destruction Slot Size: .oA, <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ❑Pressure Grout Dover Drill Type/Brand of Bentonite: t7' -i�� b...� r^ •- c�t•�.fS <br /> Filter Pack Type/Size: <br /> ❑ Gravity E�, emie El Other: Type of Method: <br /> Water Cement 47lb Water Cement 54 lb <br /> gallons Bas g2lions Baas <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix _ <br /> 2.5 5 .1 5 10 1 Bentonite per 47 Ib 1.41 <br /> 5 10' 2 10 20 2 Bentonite per 94 Ib 2.82M <br /> 7.5 15 3 15 30 3 <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 1 Stockton, California 95205 1 T' 209 468-3420 1 F 2D9 464-0138 1 www.sicehd.com <br />