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It. <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: CI Yes 0No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION CI Stove Pipe 0Christie Box <br />grout <br />ft. <br />_ft. <br />slotted <br />secdon <br />gravel pa:ic <br />ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />casing <br />height <br />CHFUSTY-130X • <br />COMPLETION <br />Ground Surface <br />From: <br />From: <br />From: <br />From: <br /> SAN JOAQUIN <br />IliTei? COUNTY <br />04013&ar / <br />loposW?". Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 3//C/2c1-1 <br />Facility Address: <br />Well Address: 31S" t?:: 41-376 <br />WP# C90 CO7P5 Well#: <br />Soil Boring#: 9--/2 <br />Drilling Company: 12, 4V.7 A'so <br />Driller Onsite: <br />Consultant: 'S VS <br />Sce <br />Geologist: <br />Public Water System Onsite: 0 Yes 0 N o <br />Domestic Well Onsite: 0 Yes IIINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes 0 No <br />SPOILS <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: El Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: l5CI: K7- <br />Depth to Water: <br />Grout Material: Ato-l- <br />Gallons of Grout Used: <br />0 Well Installation 0Well Destruction <br />El Boring Installation IBoring Destruction <br />METHOD USED <br />0Pressure Grout 0Over Drill <br />0 Gravity 0Tremie NOther: Fret 4. <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest flags Thickest Thinnest 4 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 62 <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 />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 />Inspector: -q41.1.4 <br />10/16/2017 b'‘“ <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com