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Soil Boring#: <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Da_ <br />L5i44W VelPiet-ie <br />S r_—_Nv. <br />Public Water System Onsite: LI Yes <br />Domestic Well Onsite: <br /> <br />El Yes <br />If yes, location and distance: <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal V rified: <br />Screen Length From: <br />Filter Pack <br /> <br />From: 4,3 <br />Bentonite From: <br />Grout <br /> <br />From: <br />COMPLETION CI Stove Pipe <br />U4s LINo <br />To: <br />To: ell <br />To: / <br />To: b(grfi,c-.3:, <br />sIChristie Box <br />casing <br />height <br />CHFI1STY-8OX <br />COMPLETION <br />MATERIALS DEVELOPMENT <br />Casing Type: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br /> <br />Verified Chain of Custody: El Yes ElNo <br />SPOILS <br />Contamination Noted 111 Yes ONo <br />If yes, spoils storag <br />Covered: <br />If yes, material: <br />GROUTING or <br />Depth to Wa <br />Grout Mat ial: <br />Gallons o Grout Used: <br />El Yes EINo <br />± Total Depth:,th <br />z1 • <br /> <br />AP.P° SAVOAQUIN <br />—COUNTY <br />A5eLblr/ Greatness grows here. <br />Monitoring Well/Soil <br />Date. (1-3(k. Inspector:4 q <br />Facility Address: //7-'10 <br />Well Address: /O/C— ,A7 • to-,/ <br /> <br />WP# J g _ • a Well#: <br />Environmenghealth Department <br />Isizarc.-. <br />Boring Inspection Report , <br />CONSTRUCTION <br />EWel nstallation IEIWell Destruction <br />DB ring Installation EBoring Destruction <br />M THOD USED <br />EPressure Grout DOver Drill <br />CI Gravity ETremie DOther: <br />Water <br />gallons <br />Thickest Thinnest <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br /># Bags Thickest Thinnest tt 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 />-7 BOS &yenkoNJ <br />Blank Feet Screen <br />Slot Size: <br />Bags of of Cement: 2-3 <br />Bags Sand/Gravel: ,....57136 .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 />7.--O Feet <br />13 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com