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casing <br />height <br /> <br />ABOVE-GROUND <br />CONPLETION <br /> <br /> Grocind Surfacs <br />grout <br />ft <br />A. <br />vivs4 <br />0Boring Installation ll..Bc<ring Destruction <br />METHOD USED <br />0Pressure Grout DOver Drill <br />0 Gravity ri<mie 00ther: <br /> <br />SANAAQUIN <br />COUNTY <br />Greatness grOWS here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: i'Lli3j;ff Inspector: <br />Facility Address: Sts <br />Well Address: <br />WP# Well#: <br />Soil Boring#: — ) - 0(0 <br />Drilling Company: CA-,3Coax(51_ <br />Driller Onsite: 71v-re_ <br />Consultant: <br />Geologist: <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes 0No <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <br />Public Water System Onsite: D Yes 0No <br />Domestic Well Onsite: 0 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />COMPLETION LI Stove Pipe EIChristie Box <br />Screening Method: <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: 0 Yes CINo <br />If yes, spoils storage Location: <br />Covered: E Yes EN° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 5't4 1 c24 si)f. <br />Depth to Water: <br />Grout Material: rvedr- <br />Gallons of Grout Used: tS 7,•3 zo) *), di <br />LI Well Installation 0Well Destruction <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />0 Yes DNo <br />L ft. <br />seclon <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest 4 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 />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 www.sicehd.com