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SAN40AQUIN 3 <br />COUNTY <br />Greatness grows here. <br />Environmer, Health Department <br />casing <br />height <br />CKAISTY-BOX <br />COMPLET19N <br />Monitoring Well/Soil Boring Inspection Report <br />Date: /?A/ r Inspector: <br />Facility Ad ress: <br />Well Address: / f-1, <br />VVP# le jeaU 3-M <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <-7 <br />Consultant: <br />Geologist: <br />CONSTRUCTION <br />ovr1,44,4" Fe-orA Total Depth: <br />Well#: s J.)iu1 r1 031 Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes EINo <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />COMPLETION El Stove Pipe OChristie Box <br />Public Water System Onsite: <br />111Yes ON° <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Niethod: <br />Screening Method: <br />Verified Chain of Custody: <br />111 Yes EINo <br />SPOILS <br />Contamination Noted: El Yes EINo <br />If yes, spoils storage Location: <br />Covered: LIlYes EINo <br />If yes, material: <br />1 4 eGROUTING or DESTRUCTION Total Depth:3-7-4 <br />111Well Installation [Zell Destruction <br />111Boring Installation EBoring Destruction <br />METHOD USED <br />ElPressure Grout Over Drill <br />1121rnie 1110ther: <br />Water <br />gallons <br />Cement 47 lb <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest 4 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 8 <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <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 />111 Yes EINo <br />Depth to Water: <br />Grout Material: f.1 <br />GallonsGallons of Grout Used: i..."/O chr <br />Ill Gravity <br />10/16/2017 " 1868 E. Hazelton Ky ue Stockto , California 95205 T 209 468-3420 I F 209 464-0138 [ www.sicehd.com