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—.C.O U N T Y— <br /> Greatness grows here. <br /> Monitoring 1/VO/Soill Boring Inspection Report <br /> Date: i1�h vjv Inspector: `��'��.1 \a kXAX`6" tONSTRUCTION <br /> Facility Address: &7_ta3 V�trA�o�isJc ¢�. <br /> Well Address: Total Depth: <br /> WP# Cif) N o5 tii f Well#: Drilling Rig Type: <br /> Soil Boring#: ! IS Min 2"Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: �'rJo,aP,c <br /> Driller Onsite: R,t,�Yr� k RSC Screen Length From: To: <br /> Consultant: �1�Q�. O ��`���.�J Filter Pack From: To: <br /> Geologist: Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes 1No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ YesNo casing <br /> If yes, location and distance: height <br /> WT <br /> SAMPLING ,Aaojr-_dRC'JND <br /> Holding Temperature: <br /> COMPLETION CHRCOMP�iETiota <br /> Method: Canwnast-r�i3 A, <br /> a <br /> Screening Method: groat <br /> Verified Chain of Custody: ❑ Yes ❑No ' <br /> i#. <br /> SPOILS <br /> Y-- <br /> Contamination Noted: ❑ Yes ❑No r== a <br /> If yes,spoils storage Location: at�rr�a <br /> Covered: El Yes ❑No = Pad, <br /> If yes, material: <br /> r <br /> GROUTING or DESTRUCTION Total Depth: b59 <br /> Depth to Water: A] <br /> ft. � — tt <br /> Grout Material:_ (A t*_"by <br /> MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ABoring 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 IKTrem' ie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 94 lb <br /> gall Bas allons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest #Bags Bentonite/Cement Mise 3%MIX 5%MIX <br /> 15 5 1 5 10 1 _Bentonite per 47 Ib 1.41 2.47 <br /> s 10 2 10 20 2 Bentonite per 94 Ib 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 i www.smeehd.com <br />