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$ANcJ0A0UIN Environmental Health Departmei <br /> L1i`�.sj —COUNTY— <br /> Greatness grows here- <br /> �2 Zb Monitoring Well/Soil Boring Inspection Report <br /> Date: 6 0 ( Inspector: JA Ink" CONSTRUCTION <br /> Facility Address: O $57 04,q; <br /> Well Address: 'yMAiA VJ Total Depth: 10Z5 / I ` <br /> WP# WellM ) MVJ6 Drilling Rig Type: —i 1 <br /> Soil Boring#: A I Min 2"Annular EHD Seal Verified: ❑Yes ❑No <br /> Drilling Company: uaS a <br /> Driller Onsite: m v Screen Length From: Z To: 4 <br /> Consultant: 11 \� <br /> Filter Pack From: To: � <br /> �� r� Al4;h Bentonite From: ZO To: <br /> 11 Geologist: � 2w <br /> Grout From:�..r�p,f� To:_ 2 <br /> Public Water System Onsite: ❑ Yes []No ?Zr COMPLETION ❑ Stove Pipe Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No E 1 <br /> casing <br /> If yes, location and distance: f v � height <br /> tl ' <br /> SAMPLING to2`( 001 - i Aeove.GaoUND cruilsrveox <br /> Holding Temperature: C d �� I � pN =211rioN <br /> Method: <br /> Screening Method: ��0,3) grout n I <br /> Verified Chain of Custody: ❑Yes ❑No <br /> ». <br /> Z-3 <br /> SPOILS = a <br /> Contamination Noted: ❑Yes ❑No <br /> If yes,spoils storage Location: slotted <br /> sacsign <br /> Covered: ❑Yes El NogmvW Pack <br /> = <br /> If yes, material: t _— <br /> GROUTING or DESTRUCTION Total Depth: It ✓^ 4 <br /> Depth to Water: 3 reh, ) ft. �tt• <br /> Grout Material: eak ( Dn 1 Cam` b <br /> Gallons of Grout Used: ATERIALS/DEVELOPMENT• / <br /> AS uC C' o c Sn�� I Casing Type: y <br /> (Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation El Boring Destruction . <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: — <br /> Type/Brand of Bentonite: FiAre ARe <br /> ❑Pressure Grout ❑Over Drill t <br /> E] Filter Pack Type/Size: l <br /> Gravity remie ❑Other: Type of Method: <br /> Water Cement 47115 Water Cement 94lb <br /> allons Bags gallons Ba s _ <br /> Thickest Thinnest #Bags Thickest Thinnest #Begs _Bentonite/Cement Mix 3%Mix 5"/a Mix_ <br /> 2.5 5 1 5 to 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 Ib 2.821 4.7 <br /> 7.5 15 3 is 30 3 <br /> 30 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 1s 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 30 0 <br /> 3 __ 10/16/2017 <br /> 1868 F azelton Avenue I Mckton, California 95205 l T 209 468-3420 i F 209 464-0138 l www.sicehd.com <br /> '4] r ,a <br />