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casing <br />height <br />CHI:MTV-BOX <br />006.0tETICN <br />SAN JOAQUIN <br />COUNTY <br /> Environmental Health Department <br />Greatness grows herr. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: t2-4V1 C-7 Inspector: <br />Facility Address:MO (-1/4 ---C7ôd <br />Well Address: Iv <br />WP# -71-47,/ Well#:mo/-g <br />Soil Boring#: <br />Drilling Company: Vi (A) <br />Driller Onsite: <br />Consultant: COANor, <br />Geologist: <br />Public Water System Onsite: El Yes <br />Domestic Well Onsite: El Yes dNo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: E Yes El N o <br />SPOILS <br />Contamination Noted: LI Yes N o <br />If yes, spoils storage Location: <br />Covered: El Yes LINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: <br />Gallons of Grout Used: <br />LI Well Installation LI Well Destruction <br />11Boring Installation CI Boring Destruction <br />METHOD USED <br />ElPressure Grout DlOver Drill <br />LI Gravity 171Tremie 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 # 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 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 />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type:44-0(1.)1AJ ks 4 <br />Min 2" Annular EHD Seal Verified: [Yes EINo <br />Screen Length From: j To: <br />Filter Pack From: -27 r 7-2 To: <br />To: 3 72 From: -22 ) Bentonite <br />Grout From: '2-, To: <br />COMPLETION LI Stove Pipe 0(hristie Box <br />MATERIALS/DEVELOPMENT <br />Casing Type: 2," PVC, <br />Blank '275 Feet Screen (5 . Feet <br />Slot Size: 7.0/) , <br />Bags Sand/aave lt <br />Bags of Cement: Oh Fr,• <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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com