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grout <br />4-- ft. <br /> ft. <br />_ft <br />slotted <br />..con <br />Jr <br />grave pack <br />ft. <br />casing <br />height <br />CHRISTY-80X <br />CQMPLETION <br />Ground Surf acs <br />SANIJOAQUIN <br />COUNTY <br />Greatness grows her e. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: k-/1 [14/ Inspector: <br />Facility Address: Address: 3-7S--_I 11.4,ve,11-•." 64-1/ <br />Well Address: <br />WP# Well#: <br />Soil Boring#: <br />Drilling Company: _A-6-F <br />Driller Onsite: ice itt, <br />Consultant: A-&-,F <br />Geologist: <br />Public Water System Onsite: LI Yes DNo <br />Domestic Well Onsite: Li Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: D Yes ON° <br />SPOILS <br />Contamination Noted: LI Yes ON° <br />If yes, spoils storage Location: <br />Covered: El Yes El o <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: <br />III Well Destruction <br />OBoring Installation ClBoring Destruction <br />METHOD USED <br />111Pressure Grout ElOver Drill <br />1P rravity ElTremie ElOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest # Bags <br />2.5 5 1 5 10 1 <br />s 10 2 10 20 1 <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 Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes <br />Screen Length Length From: SA-- To: b-fk <br />Filter Pack From: To: •-r43- Co*" <br />Bentonite From: kk To: <br />Grout From: 0 To:—CLA <br />COMPLETION CI Stove Pipe Rtcristie Box <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 />Gallons of Grout Used: <br />Fi(Vell Installation <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