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a: b:, �. Lira MI rV vii y U i I'm tflVl(�011Tf1��1L�1 �leaarai Lfupd'r f1f1em <br /> 1F <br /> r `i —COUNTY— <br /> Greatness gronws nere. <br /> Mon,_.,ring Well/Soil Boring Inspectic keport <br /> Date: 11 1 Inspector: �- b CONSTRUCTION <br /> Facility Address: 11011 k .-6-4 <br /> Well Address: Total Depth: 1--�73 <br /> WP# 00)V!E�{(j Wellk ( orA5 O Drilling Rig Type: rvwA n!b.� <br /> Soil Boring#: �/ <br /> DrillingCompany: l� (.., Min 2"Annular EHD Seal Verified: li; es ❑No <br /> Driller Onsite: O Screen Length From: 2,, 5,& To: <br /> Consultant: �7.oS�v�see� Filter Pack From: To: 2-)3 flr <br /> Geologist: Bentonite From: To: ISO <br /> Grout From: To: ?,(4f <br /> Public Water System Onsite: ❑Yes ❑No COMPLETION N7, tove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: T r,aiglzt <br /> SAMPLING A-wVE-GROUND • • <br /> Holding Temperature: ctWra <br /> Method: <br /> Screening Method: ar° <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> it. <br /> #t. <br /> SPOILS = <br /> 4S <br /> Contamination Noted: ❑ Yes ❑No <br /> If yes, spoils storage Location: tr <br /> 1�4fi � <br /> Covered: ❑Yes ❑No _ <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: <br /> Depth to Water: - —F <br /> Grout Material: MATERIALS/DEVELOPM.ENT <br /> Gallons of Grout Used: <br /> _ Casing <br /> FtNell Installation ❑Well Destruction Blank Feet Screen 5' Feet <br /> Slot Size: . Oka <br /> ❑Boring Installation ❑Boring Destruction Bags iz Cement: <br /> METHOD USED Bags Sand/Gravel: W <br /> ❑Pressure Grout Dover Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity E47"remie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> allons Bas Rallons Baes <br /> Thickest Thinnest 4Bags Thickest Thinnest #Bags BentonitelCement 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 2.82 4.7 <br /> 75 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 4 <br /> 20 40 B 40 BO 8 �� <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T' 209468-34201 F 209464-0138 1 www.sicehd.com <br /> g 4-1 4'. / 140 111 <br />