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casing <br />height <br />ft <br />SANAOAQUIN <br />—C N TY— \ , .s.t. Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Nntlc ,),(3 Inspector: K,.Sae,:\-er-c-N <br />Facility Address: 2-13-3C-A <br />Well Address: <br />WP# Well#: <br />Soil Boring#: <br />Drilling Company: 1,AcIsot.:, \‘';‘-,c1 ICY <br />Driller Onsite: •Pckvc?c <br />Consultant: <br />Geologist: <br />Public Water System Onsite: D Yes ON° <br />Domestic Well Onsite: D Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 1=1 Yes ILINo <br />SPOILS <br />Contamination Noted: El Yes ON° <br />If yes, spoils storage Location: <br />Covered: EIYes 1=INo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: DOC' <br />Depth to Water: <br />Grout Material: -)ecl-R-,61\-e Z <br />Gallons of Grout Used: <br />Well Installation El Well Destruction <br />ID Boring Installation DBoring Destruction <br />METHOD USED <br />ressu re Grout DOver Drill <br />11 Gravity OTremie DOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />scallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest *Bags Thickest Thinnest 4Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 2 <br />7.5 15 3 15 30 3 <br />111 20 4 20 40 4 <br />12.5 25 5 25 50 5 <br />15 30 6 30 - 80 6 <br />17.5 35 7 35 70 7 <br />20 _ 40 - 8 40 80 8 <br />CONSTRUCTION <br />Total Depth: ,a00` <br />Drilling Rig Type: muck Rokcni <br />Min 2" Annular EHD Seal Verified: El Yes Li No <br />From: To: <br />From: To: <br />From: To: <br />From: To: <br />COMPLETION ID Stove Pipe [I] Christie Box <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 S% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <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