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triviieolunentli ñéh ueARTITiet <br />MoniL,ring Well/Soil Boring Inspectiorl Report <br />Date: it /t-4//3 Inspector: <br />Facility Address: I I 07,7 l-totac-,40 ie-e/ <br />Well Address: <br />WP# cA, 2/MAT Well#: <br />Soil Boring#: - / — - <br />Drilling Company: CA-sc....0-4- ,f)rrliirmAA <br />Driller Onsite: (2. <br />Consultant: 614D , <br />Geologist: <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2' Annular EHD Seal Verified: 0 Yes 17l1No <br />To: <br />To: <br />To: <br />To: <br />Covered: 0 Yes 0 No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 1.5ft-) <br />Depth to Water: S-1-6 n vi <br />Grout Material: <br />Gallons of Grout Used: 1243 toj <br />OWell Installation EilWe I Destruction <br />El Boring InstallationN•fr6i-ing Destruction <br />METHOD USED <br />flPrue re Grout IllOver Drill tys, <br />Gravity &Kemie 1110ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest # Bags <br />25 5 1 5 10 1 <br />5 10 2 10 20 2 <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 BO B <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-34201 F 209 464-0138 I www.sioehd.com <br />Public Water System Onsite: . CI Yes ON° <br />Domestic Well Onsite: 0 Yes 111No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: LI Yes ON° <br />SPOILS <br />Contamination Noted: El Yes LIN° <br />If yes, spoils storage Location: <br />casing <br />height <br />ABOVE-GROUND <br />coh-PLEnou <br />COMPLETION El Stove Pipe IiiChristie Box <br /> Grocinci Stsrf2c4a <br />slotted <br />saction <br />2.Sieb <br />rtit ff. <br />COUNTY— <br />Greatness qrows here. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: