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ABOVE-GROUND <br />COMPLETION <br /> SANJOAQUIN <br />COUNTY <br />\Ns<11111**7:// Greatness grows here. <br />Date: -2- Nit el <br />Facility Address: 3 f WI' 5+ <br />Well Address: <br />WP# D031141 Well: e4vJ <br />Soil Boring#: <br />Drilling Company: tv--101 <br />Driller Onsite: (2.0 6 <br />Consultant: Pr(51:. <br />Geologist: <br />Public Water System Onsite: E Yes EINo <br />Environmental Health Department <br />Total Depth: ?-c-f , <br />Drilling Rig Type: )40 tik4 <br />Min 2" Annular EHD Seal Verified: r_Si4es El No <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION E Stove Pipe JNChristie Box <br />Monitoring Well/Soil Boring Inspection Report <br />Inspector: 1.-s,e- .)60-•-y CONSTRUCTION <br />From: To: 2- <br />From: Li To: -7.43 <br />From: 1— To: <br />From: C> To: 2.1 <br />Domestic Well Onsite: E Yes IIINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />Ground Sudan <br />Screening Method: <br />Verified Chain of Custody: CI Yes DNo <br />SPOILS <br />Contamination Noted: El Yes El No <br />If yes, spoils storage Location: <br />Covered: E Yes ENo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: (1* <br />Grout Material: Nto)r _biv-s-vs-Ar 43) <br />Gallons of Grout Used: 1,) <br />NWell Installation ElWell Destruction <br />ElBoring Installation EBoring Destruction <br />METHOD USED <br />Pressure Grout 00ver Drill <br />Gravity DTremie ZOther: t-w.i. .4 44 <br />Water <br />_ gallons <br />Cement 47 lb <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest r:Bags Thickest Thinnest /*Bags <br />2.5 5 1 s 10 1 <br />s 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 s <br />15 30 6 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />MATERIALS/DEVELOPMENT <br />Casing Type: P ic., 5.1"4"10 <br />Blank S" Feet Screen t5--- Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: t 6696 <br />Type/Brand of Bentonite: ir4.-cdvvwsAA- -1445- <br />Filter Pack Type/Size: lig" 3 <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 />ft. <br />slotted <br />sacton <br />Jr <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 www.sicehd.com