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vse, <br />ft. <br />casing <br />height <br />ABOVE-GROUND <br />CO IVPLEMN CHRISTY-BOX <br />COMPLETION <br />C3rour4 Surfacs <br />grout <br />ft. <br />ft. <br />SAWsJOAQUIN <br />— COUNTY Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: (q11/514 Inspector: <br />Facility Address: 1-7,1/S °•-sal*--) <br />Well Address: <br />WP# 00 V42,-(0 Well#: <br />Soil Boring#: vp-tit.-- B*4 <br />Drilling Company: Ciascx...(4. <br />Driller Onsite: <br />Consultant: Ca v,-Cle E.0.41,1 <br />Geologist: <br />Public Water System Onsite: E Yes ENo <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 171 Yes ON° <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 0 Stove Pipe 0Christie Box <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout From: <br />Domestic Well Onsite: 0 Yes EN° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes III No <br />SPOILS <br />Contamination Noted: LI Yes El No <br />If yes, spoils storage Location: <br />Covered: LI Yes ENo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth:2.4 <br />Depth to Water: LS-4'V <br />Grout Material: A.( CAAAN.D.A-A— <br />Gallons of Grout Used: <br />9 11, 5.i. • <br /> 1 3 I t s) <br />Well Installation EWell Destruction <br />LI Boring Installation 11176ring Destruction <br />METHOD USED <br />Pressure Grout EOver Drill <br />El Gravity P1<emie 00ther: <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 />Water <br />gallons <br />Cement 47Ib <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 8 <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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com