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Feet Blank Feet Screen <br />MI'4)UMLJU I II <br />—COUNTY— , <br />5- Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />trIvIrofirTiOnTai fieaTLA u&pietTherlit <br />Date: 1k ski cg Inspector: L.,- <br />Facility Address: 6,14 trio-at eniv-e-- <br />Well Address: <br />WP# 3ff9 5-2_ Well#: <br />Soil Boring#: Ce1-73 (02- • <br />Drilling Company: (rrei5 <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: . D Yes ENo <br />Domestic Well Onsite: 0 Yes LIND <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes El No <br />SPOILS <br />Contamination Noted: 0 Yes D No <br />If yes, spoils storage Location: <br />Covered: E Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: Cv2 <br />Depth to Water: ci, <br />Grout Material: <br />Gallons of Grout Used: to 85 <br />- ) <br />EWell Installation ElWell Destruction <br />OBoring Installation aler--ing Destruction <br />METHOD USED <br />EPressure Grout EOver Drill <br />LI Gravity ai<rmie E0ther: <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 />2.5 5 1 5 10 1 <br />5 Hi 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 80 8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: [i Yes IENo <br />To: <br />To: <br />To: <br />To: <br />COMPLETION D Stove Pipe <br />casing <br />height <br />0 Christie Box <br />ABOVE-GROUND <br />COWLETICIN <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />MATERIALS/DEVELOPMENT <br />Casing Type: <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 209 468-3420 I F 209 464-0138 I www.sioehd.com <br />r--eriCA"-•