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f� ilH 1Y2J URIJU III EnvironMental Neaim L1e15c'tP'1ZP"➢i ent <br /> 1".�11.L! `� —C OU NTY— <br /> \44�r�` Greatness grows here. <br /> Monito`iing Well/Soil Boring Inspection Report <br /> Date: I1 19 Inspector: Jttd CONSTRUCTION <br /> Facility A dress: 7 tgS I A 1 t,"a <br /> Well Address: t Total Depth: <br /> Wp# (JU C ply Well#: C(TI, S(sL ,3(-1 Drilling Rig Type: <br /> Soil Boring#: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Drilling Company: Screen Length From: To: <br /> Driller Onsite: <br /> Filter Pack From: To: <br /> Consultant: <br /> S•)inh�M �Uw• Bentonite From: To: <br /> Geologist: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe ❑Christie Box <br /> Domestic Well Onsite: ❑ Yes EINo aasins <br /> If yes, location and distance: height <br /> SAMPLING AaovS"&ROUN0 itsrYaox " <br /> Holding Temperature: COWLETTON COWLETTON <br /> (3ccxind Sw'fxa <br /> Method: <br /> Screening Method: JIL <br /> °r <br /> Verified Chain of Custody: ❑ Yes ❑No <br /> SPOILS <br /> v: a <br /> Contamination Noted: 0 Yes ❑No H <br /> If yes, spoils storage Location: all i <br /> aac)cn � •- '� <br /> Covered: ❑ Yes ❑No <br /> If yes, material: _ <br /> GROUTING or DESTRUCTION Total Depth: G s —tO'6C <br /> Depth to Water, O <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: 4,. . AlaJ .15 � Casing Type: <br /> ❑Well Installation []Well Destruction Blank Feet Screen Feet <br /> Slot Size: <br /> ❑Boring Installation El Boring Destruction Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout Dover Drill Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water cement 471b Water Cement 941b <br /> gall o is Bags ailons Bags <br /> Thickest Thinnest 37 Bags Thickest Thinnest #Bags BentaniteJCement Mix 3°J° tt�tix 3% fl+11K_ <br /> 25 5 i 5 10 1 Bentonite per 47 lb 1.41 2.47 <br /> 5 10• 2 10 20 2 Bentonfte per 94lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 , i <br /> i n 25 5 25 50 5 8t 4-r � —I b <br /> 15 30 6 30 60 6 <br /> 175 95 7 35 70 7 4j2-t°•r`g- <br /> 20 40 ° 40 1 90 18 <br /> 10/16/2017 <br /> Sfyt J S 1 1 45 54�2. 5 &-u 1 5b�'/ <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T' 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br /> L�l,nl I�' ZII IJ'•y° lJ�•S" lD',S'� w15,1 <br /> I ta�_A <br />