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COUNTr_■■�uv■...■v■■rra■ ■ ■vra■r■. vv a.■ u■■�.■■r Y— r' Greatness grows here. Monitoring Well/Soil Boring Inspection Report Date: tol 17z 1 9 Inspector: 4, , CONSTRUCTION Facility ddress: 2-12-2-3S- A.•a Y. �.! Well Address: Total Depth: WP# Q03bZZ Well#: Drilling Rig Type: Soil Boring#: Z- Min 2"Annular EHD Seal Verified:. ❑ Yes ❑No Drilling Company: Kra 7 CA, � A sSoe.ee�-lS, ze Driller Onsite: �'w�t Screen Length From: To: Filter Pack From: To: Consultant: Geologist: Bentonite From: To: Grout From: To: Public Water System Onsite: ❑Yes ❑No COMPLETION ❑Stove Pipe ❑Christie Box Domestic Well Onsite: ❑Yes ❑No casing If yes, location and distance: m ight HT- 0 SAMPLING govt-GROUND Holding Temperature: COhPLErlahl GcomP*7VL3_nom Method: GmUnd Surra + — Screening Method: er� Verified Chain of Custody: ElYes ❑No " ft_ SPOILS _= Contamination Noted: ❑ Yes ❑No = o _ If yes, spoils storage Location: sbrnd = a ssc'cn - Covered: ❑Yes ❑No = � If yes, material: = _ GROUTING or DESTRUCTION Total Depth: (,a-fil� Depth to Water: 4I040 Grout Material: /ltv!- C°t I"A— MATERIALS/DEVELOPMENT Gallons of Grout Used: n C4 3o!s. Casing Type: ❑Well Installation ❑Well Destruction Blank Feet Screen Feet Slot Size: ❑Boring Installation 14B ring Destruction Bags of Cement: METHOD USED Bags Sand/Gravel: ❑Pressure Grout Dover Drill Type/Brand of Bentonite: Filter Pack Type/Size: ❑ Gravity 171'remie ❑Other: Type of Method: Water Cement 471b Water Cement 941b Ilons Bags wall ons Baas Thickest Thinnest 9Bags Thickest Thinnest ABags Bentonite/Cement Mix 3% Mix 5% Mix Z5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 5 10' z 10 20 2 Bentonite per 941b 2.82 4.7 7,5 15 3 15 30 3 1 1 i 1 i 125 25 5 25 50 55 1 30 30 0 'S 2 3 17.. 7 7 7 5 35 7 35 70 7 7 1 20 40 8 40 80 0 Zo tjz 4- y 47 [b 10/16/2017 1868 E. Hazelton Avenue I Stockton, California 95205 1 T' 209468-34201 F 209464-0138 1 www.sicehd.com