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casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHRISTY-BOX <br />COMPLETION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: CI Yes ONo <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 0 Stove Pipe OChristie Box <br />Ground Burton <br />grout <br /> tt <br />t t <br />slotted <br />socdon <br />Jr <br />gravoi pack <br />ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />Environmental Health Department fr <br /> SAN.d0AQUIN <br />COUNTY <br />,m- <br /> Greotness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: \t11:5\2A Inspector: 5-fx•Vrv it, CONSTRUCTION <br />e_ Icc\c, J.V <br />LiAvrap, <br />\A/13# QO'2Z.. Well#: <br />crCSoi I Boring#: C.I?1- \A CPT <br />Facility Address: <br />Well Address: <br />Drilling Company: 61QL) E•X <br />- Driller Onsite: CAL <br />Consultant: C-Aej;) <br />Geologist: <br />Public Water System Onsite: 0 Yes LINo <br />Domestic Well Onsite: 0 Yes ONo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />Covered: 0 Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: \OCRA- <br />Depth to Water: 25 <br />Grout Material: Q91rvik <br />Gallons of Grout Used: <br />OWell Installation LI Well Destruction <br />Boring Installationoring Destruction <br />METHOD USED <br />Pressure Grout 00ver Drill <br />D Gravity Naremie Other: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest *Bags Thickest Thinnest flags <br />2.5 5 1 5 10 1 <br />5 10 2 vr— 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 />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 />0 Yes LIN o <br />0 Yes ON° <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