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Facility A dress: C\) S \c4k/Lt -4 <br />1-404t14). <br />Date: '3 lnsp t r: C..x\Zr‘0,..4) <br />Well Address: <br />WP# 00 1(5 75 Well#: <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />gravel pa=k <br />ft. <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION CI Stove Pipe OChristie Box <br />Ground Surface <br />f <br />grad <br />ft <br /> ft <br />-ft <br />slotted <br />secdon <br />Ii <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />SAN ,JOAQUIN tam, COUNTY <br />05=0", 04,,' Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Soil Boring#: C <br />Drilling Company: <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: n Yes <br /> 171 No <br />Domestic Well Onsite: <br /> <br />O Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes El No <br />SPOILS <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: El Yes 0 No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 50Ck <br />Grout Material: <br />Gallons of Grout Used: 15q# <br />Depth to Water: <br />N DiA10-4 <br />\k • <br />0Well Installation 0Well Destruction <br />Boring Installation MBoring Destruction <br />METHOD USED <br />Pressure Grout 00ver Drill <br />0 Gravity <br /> <br />R-Tremie 00ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest *Bags Thickest Thinnest 4 Bags <br />2.5 5 1 V 5 10 1 <br />5 10 2 t/ 10 20 2 <br />7.5 15 3 15 30 3 <br />10 20 4 20 40 4 <br />1/5 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 />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 />10/16/2017 <br />I-Atactle taWn <br />cik.) <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com