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Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />111 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />Groura:1 Surfac• <br />111 Stove Pipe CIChristie Box COMPLETION <br />ABOVE-GROUND <br />COMPLETION <br />casing <br />height <br /> <br />CHRISTY-BOX <br />COMPLETION <br /> <br />(1(‘:\ SANJOAQUIN Environmental Health Department <br />-,t1E11117:"; <br /> <br />COUNTY -- <br />I <br />.4:1,,,,,„ry Greatness grows here <br />Monitoring Well/Soil <br />Date:9 .I Inspector: Ci-1' i 0` A ' <br />Facility ddress: 22)(y( Pt Lew --(--- <br />, Well Address:Address: S . exS6144±- "4- <br />V V P # 00141% Well#: V/Vi Vi--() I <br />Soil Boring#: <br />Drilling Company: R i-C-kbr SerlA 6P--)1 <br />Driller Onsite: Wi ll y <br />Consultant: L;lri t i••• A--0 —re_cili <br />Geologist: <br />Public Water System Onsite: 0 Yes 0No <br />Domestic Well Onsite: El Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />0 Yes 0No Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: 0 Yes El No <br />If yes, spoils storage Location: <br />Covered: 0 Yes <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: (2..5 P4 Lis -P-f- <br />Depth to Water: r.2 <br />Grout Material: //MAT" Ce~—f" <br />Gallons of Grout Used: r-t-- Li 0 <br />OWell Installation Yell Destruction <br />El Boring Installation 111Boring Destruction <br />METHOD USED <br />CI Pressure Grout)4ver Drill <br />0 Gravity t1Tremi Other: <br />A <br />" HsA <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 />Water <br />gallons <br />Cement711(2...:,) <br />Bags <br />Water <br />gallons <br />Cennent941b <br />Bags <br />Thickest Thinnest It Bags Thickest Thinnest #13ags <br />2.5 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 80 8 <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 />(PA ib&i S <br />cri 2:3 60A S <br />1868 E. Hazelton Avenue I Stitickton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com <br />10/16/2017