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SANAOAQUIN <br /> <br />7.. _ <br /> <br />4mooti COUNTY <br />Greatness grows here --•,',41./FocA" <br />Environmental Health Department <br />Q e_ir (0""-S CONSTRUCTION <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: `1 <br />From: <br />From: 0 <br />LII No COMPLETION El Stove Pipe AChristie Box Public Water System Onsite: El Yes <br />Ground Stxfacs <br />casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHRISTY-BOX <br />COMPLETION <br />Domestic Well Onsite: 0 Yes 111No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />LI Gravity ETremie gOther: .4A <br />Monitoring Well/Soil Boring Inspection Report <br />Date:///?f Inspector: bc <br />Facility Address: 3 $*- <br />Well Address: <br />WP# t-410 Well#: <br />Soil Boring#: <br />Drilling Company: #1,410% <br />Driller Onsite: R-(110 <br />Consultant: Psy <br />Geologist: a-c,..„2_, <br />Screening Method: <br />Verified Chain of Custody: LI Yes ON° <br />SPOILS <br />Contamination Noted: 0 Yes ON° <br />If yes, spoils storage Location: <br />Covered: 0 Yes ENo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 2, <br />Depth to Water: 114, <br />Grout Material: 1\c...4" C_c-6-4../--4-- <br />Gallons of Grout Used: ni <br />tkell Installation OWell Destruction <br />LI Boring Installation El Boring Destruction <br />METHOD USED <br />OPressure Grout nOver Drill <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 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 />grout <br />ft <br /> ft <br />slottad <br />sac-ion <br />ft I <br />gravst pack <br />MATERIALS/DEVELOPMENT <br />Casing Type: P"k/C.- <br />Blank 3" Feet Screen les' Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: t' kwig, <br />Type/Brand of Bentonite: t",.01...-v-L_ <br />Filter Pack Type/Size:liC 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 />1868 E. Hazelton Avenue I Stockton, California 95205 I 1 209 468-3420 I F 209 464-0138 I www.sicehd.com <br />Total Depth: Loa, <br />Drilling Rig Type: AA,. <br />Min 2" Annular EHD Seal Verified: <br />ft. <br />N o <br />To: 20 <br />To: t.e.) <br />To: 4 <br />To: Z-