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Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Mn 2," Annul r EHD Seal Verified: <br />Sra qdrigth From: <br />Filter Pack From: ,...c4 <br />Bentonite From: <br />Grout From:. - <br />COMPLETION El Stove Pipe <br />131‹s <br />To: <br />To: LI <br />To: <br />To: •6- <br />1E11--iristie Box <br />EINo <br />CAA-41144.-)Itn <br />casing <br />height <br />SAN Anti! <br />COUNTY <br />Greatness gra. <br />Environme..tal Health Department <br />Monitoring Well/Soil <br />Date:iiJ -7 Inspector: ri“-"/ 14%, <br />Facility A dress._45(a S <br />Well Address: <br />WP#pf (Jo s Well#: -I <br />Soil Boring#: <br />Drilling Company: /e-r _Or d PAO <br />Driller Onsite: ul <br />Consultant:5 <br />Geologist: kfavt 1.--?ktk <br />Public Water System Onsite: 0 Yes u/No <br />Domestic Well Onsite: <br /> 111 Yes Q4'4o <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 111 Yes 111 No <br />SPOILS <br />Contamination Noted: El Yes El No <br />If yes, spoils storage Location: <br />Covered: 0 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: <br />Gallons of Grout Used: <br />0Well Installation aP6'ell Destruction <br />ClBoring Installation ill Boring Destruction <br />METHOD USED <br />O <br />i <br />P essure Grout 00ver Drill <br />Gravity lilTremie ElOther: <br />Water <br />gallons <br />Cennent471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest #Bags Thickest Thinnest #Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 <br />7.5 15 3 15 30 3 <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 a <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 7 Feet Screen Feet <br />Slot Size: <br />1/3 <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16/2017 <br />Bags of Cement: <br />Bags Sand/Gravel: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com