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SAN JOAQUIN <br />COUNTY <br />, <br />G reatness grows here <br />Environmei I Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 114V1i/1 Inspector: 1---ikr )(.40v• <br />Facility Address: 401 5revto-ten <br />Well <br />- <br />Well Address: <br />WP# <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: We11#: <br />Soil Boring#: 04-t-/n fitv-14 _min 2" Annular EHD Seal Verified: Drilling Company: Ve.,"Avq/A kow "11- 6" /- V <br />..4Liciewpigsgti.een Length Driller Onsite: <br />Consultant: <br />Geologist: 1.-vAwkst"twiN ,0\tors7 <br /> SFilter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />Yes UNo <br />To: <br />To: <br />To: <br />To: <br />Public Water System Onsite: El Yes ENo <br />COMPLETION D Stove Pipe <br /> <br />E1Christie Box <br />Domestic Well Onsite: Yes IiINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: D Yes ONo <br />SPOILS <br />Contamination Noted: El Yes LINo <br />If yes, spoils storage Location: <br />Covered: I=1 Yes EINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth:.- 9 AA 7-01 <br />Depth to Water: 754)40--- <br />Grout Material: cv...k eA/v\eiv\PT <br />Gallons of Grout Used: 10.51 /7-9 / 121 <br />El Well Installation DWell Destruction <br />D Boring Installation 116ring Destruction <br />METHOD USED <br />D Pressure Grout DOver Drill <br />CI Gravity Other: <br />Water <br />gallons <br />Thickest Thinnest <br />cement 47113 <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />/nags 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 e <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />ft <br />ft. <br />--ft. <br />slotted <br />saclon <br />ft. <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 />10/16/2017 <br />tt. <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com