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COMPLETION ID Stove Pipe <br />casing <br />height <br />Rtthristie Box <br />CHPILSTY-BOX <br />COMPLETION <br />MATERIALS/DEVELOPMENT <br />Casing Type: Sc,4— 4,0 <br />Mm 2" 2" Annular E <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />HD Seal Verified: l'"/-es ENo <br />From: "to To: 35- <br />From: WJ To: 33 <br />From: 33 <br />From: <br />To: 3( <br />To: 0 <br />SANAOAQUIN <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: 4404 <br />Drilling Rig Type: \-to <br />Facility Address: 1 Il t"k St . <br />Inspector: I—sr- cn <br />Well Address: <br />WP# 31z:se <br /> <br />We11#: Mval <br />Soil Boring#: <br />Drilling Company: hopi <br />Driller Onsite: gob <br />Consultant: (.7 „,414A— <br />Geologist: <br />Public Water System Onsite: Yes ElNo <br />Domestic Well Onsite: E Yes ENo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: E I Yes E No <br />SPOILS <br />Contamination Noted: E Yes 111No <br />If yes, spoils storage Location: <br />Covered: 111 Yes IIINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: -5 <br />Depth to Water: <br />Grout Material: /N o-A- C....e."/.4AAIV" <br />Gallons of Grout Used: 200/ 10) <br />IglWell Installation CI Well Destruction <br />E Boring Installation EBoring Destruction <br />METHOD USED <br />EPressure Grout 1110ver Drill <br />I Gravity <br /> 1110ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest /*Bags Thickest Thinnest //Bags <br />2.5 5 1 s 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 />Blank Feet Screen S Feet <br />Slot Size: 0-17..,P <br />Bags of Cement: <br />Bags Sand/Gravel: 3 15..s _s <br />Type/Brand of Bentonite: c) <br />Filter Pack Type/Size: 0.1 <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 />14 (LI) <br />Ht) <br />10/16/2017 <br />fkA, <br />Ylk <br />Date: 2174 /11 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com