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casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHRISTY-BOX <br />COMPLETION <br />Ground Surfacs <br />-ft <br />SANdOAQUIN <br />—COUNTY -- <br />\&:14412311"/ Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 21 Inspector: 5CA ti\.(A.S <br />Facility Address: tg. 5 1tt...-e-i cc 1.c.,- Pti . <br />Well Address: LdkiNtrof <br />WP# D tkkii '2-1 Well#: <br />Soil Boring#: C\--1- tiC,_,P7 8 <br />CONSTRUCTION <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 />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />Public Water System Onsite: El Yes ON° COMPLETION El Stove Pipe lilChristie Box <br /> <br />Domestic Well Onsite: El Yes lilNo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: LIlYes ON° <br />SPOILS <br />Contamination Noted: El Yes ON° <br />If yes, spoils storage Location: <br />Covered: El Yes 171No <br />If yes, material: <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 />GROUTING or DESTRUCTION Total Dept11; 10041 10 0 4. <br />Depth to Water: -7.C; <br />Grout Material: 6P-ivertrr 141 )Scrut. <br />LI Well Installation Li Well Destruction <br />Gallons of Grout Used: <br />III Boring Installation 0:: zoring Destruction <br />METHOD USED <br />LIPressure Grout ElOver Drill <br />CI Gravity UTremie pOther: <br />Water <br />gallons <br />Thickest Thinnest <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />8 Bags Thickest Thinnest //Bags <br />2.5 5 1 5 10 1 <br />5 10 25-' 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.sjcehd.com