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� 8N |M8�lD|N <br /> , JA|V �QA�U||V <br /> Environmental <br /> ' ---[oumTY--' '—' --^ <br /> G, umrvsym", �r,c <br /> Monitoring VVeU /SOUBoring Inspection Report <br /> Date: V <br /> -6- W inspector: CONSTRUCHON <br /> Facility Address: <br /> Well Address: Total Depth: <br /> Soil Boring#: L)3 Min 2"Annular EHD Seal Verified: El Yes El No <br /> Drilling Company:-' Vfv <br /> Driller Onsite: Screen Length From: To: <br /> Consultant: A(6 o Filter Pack From: ______ m: ___�______ <br /> Geologist: Bentonite Frono� To: __________ <br /> Grout Frono� To: __________ <br /> Public Water System Onsite' []Yes []Nu <br /> ' COMPLETION LJStove Pipe [][hristieBox <br /> Domestic Well Onsite: [] Yeo []No <br /> casing <br /> |fyes, location and distance: height ' <br /> 3AW9UN } <br /> Holding Temperature: #zwpL�uzm COMPLETiON <br /> ^~^'—~^ <br /> Method: a«mmmmux°ce <br /> Screening Method: <br /> Verified Chain of Custody: [] Yes []No <br /> SPOILS <br /> Contamination Noted: [] Yes []No � <br /> T_ 2 <br /> |fyes,spoils storage Location: <br /> *lortgd = <br /> � ! <br /> Covered: [] Yes []No — n9_Vw Pack <br /> � <br /> If yes, material: <br /> to ,/ -1 66 =—] 1-w <br /> GROUTING or DESTRUCTION Total Depth: _ 71 <br /> DepthtoVVater t.� ��_j <br /> Grou1Materia|: MATERIALS/1DEVELOPM ENT <br /> � <br /> Gallons ofGrout Used: / <br /> - Casing Type: <br /> []VVe!| |nsta|/adon []VVe|/ Destruct/on Blank Feet Screen Feet <br /> Slot Size: <br /> L]Bohn8|n�aUot|on QDestruction <br /> ^~`�—'— Bags ofCement: <br /> METHOD USED Ba8s3ond/Grave|: <br /> Type/8randofBentonhe� <br /> OP��ueGmut Dover Drill <br /> Filter Pack lype/3be: <br /> El Gravity `&Tr~mie []Other: Type ofMethod: <br /> Water Ce!ment 471b Water Cement 94 1 b <br /> B:;4�:] <br /> aallons gallons Bags <br /> Thickest Thinnest Bags Thickest Thinnest 9 Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> ' <br /> Bentonite per 94 lb 2.82 4.7 <br /> 10 20 4 20 40 4 <br /> 15 30 6 30 60 6 <br /> 10/l6/2017 <br /> Y888[. Hazelton Avenue/ Gtouhton, California 05285 / T 209 468-3420 F 209 464-0138 <br />