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ft. <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: E Yes ENo <br />To: <br />To: <br />To: <br />To: <br />COMPLETION LI Stove Pipe EChristie Box <br />grout <br />_ft. <br />slotted <br />s•cdon <br />ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br /> Ground Sixfacs f <br />From: <br />From: <br />From: <br />From: <br />SAN JOAQUIN <br />COUNTY <br /> Environmental Health Department <br />Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 12121,1 1+ Inspector: 2 ' le)o-rIC-Cr <br />Facility Address: (401- 60v..4_sis iv1&xvo.e.L0- <br />Well Address: <br />WP# 00 Well#: <br />Soil Boring#: Ovvii —SV <br />Drilling Company: v avoN C.C-t 1-4.1-1"vicAl'aS <br />Driller Onsite: bey, e.00ver <br />Consultant: <br />Geologist: Eric e°,4t.c Ct- <br />Public Water System Onsite: <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: E Yes ENo <br />SPOILS <br />Contamination Noted: El Yes 1=1 N o <br />If yes, spoils storage Location: <br />Covered: E Yes ENo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 15 <br />Depth to Water: No tAie.4eir <br />Grout Material: <br />Gallons of of Grout Used: J Atto#,.5 <br />EWell Installation EWell Destruction <br />LI Boring Installation oring Destruction <br />METHOD USED <br />EPressure Grout EOver Drill <br />cgr.Gravity ETremie ElOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons . <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest #Bags <br />2.5 5 1 s 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 a 40 80 8 <br />CONSTRUCTION <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 />E Yes No <br />Yes <br />10/16/2017 <br />(14-+ \I's) ?4-1r attilOvLS 0 Wool-tf <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com