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1" ' —COUNTY— 'M.,. .. —....--..AL. . ._X.J.. L _�LA <br /> r <br /> Greatness VOWS here. <br /> Monis„ ring Well/Soil Boring Inspectic, Report <br /> Date: Inspector: CONSTRUCT10N z <br /> Facility Address: loo ,20-0• <br /> Well Address: L-..,,,m w'► Total Depth: <br /> WP# <N3'4563 Well#. 7,0W ZZ�`�A Drilling Rig Type: <br /> Soil Boring#: <br /> Drilling Company: Min 2”Annular EHD Seal Verified: El Yes ❑No <br /> Driller Onsite: Puc ft".b Screen Length From: To: <br /> Consultant: Ayy . �� '� �•1i Filter Pack From: To: <br /> Geologist: T-C V"n4o-✓ <br /> Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes El No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No C.5jMg <br /> If yes, location and distance: height <br /> SAMPLING ABOV.%&aOUyD <br /> Holding Temperature: �wLErFQH COWLETiON <br /> Method: GC°"r"dsL:rf°°' <br /> Screening Method: Hft <br /> Verified Chain of Custody: ❑ Yes ❑No '�- <br /> r3. <br /> #t. <br /> SPOILS = _ <br /> 49 <br /> Contamination Noted: ❑ Yes []No <br /> If yes, spoils storage Location: s :>� <br /> Covered: ❑Yes ❑No __ <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: — <br /> Depth to Water: - ' <br /> Grout Material: J\.cr- Ct MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used:'' <br /> � Casing Type: <br /> []Well Installation IEWell Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> ressure Grout ❑Over Drill Type/Brand of Bentonite: <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bas Rallons Bags <br /> Thickest Thinnest 9Bags Thickest Thinnest #Bags Bentonite/Cement Mix 3% Mix 5% Mix <br /> 2.5 5 s 5 10 1 _Bentonite per 47 Ib 1.41 2.47 <br /> 5 10' 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7,5 15 3 15 30 3 <br /> 1 I i I <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 /> 10/16/2017 <br /> 1868 E. Hazelton Avenue J Stockton, California 95205 1 T' 209 468-34201 F 209 464-0138 J www.sicehd.com <br />