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grave4 pack <br />ft. Jr <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: CI Yes EINo <br />To: <br />To: <br />To: <br />To: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br />From: <br />COMPLETION 111 Stove Pipe El Christie Box <br />casing <br />height <br />ABOVE-GROUND <br />COWLET/ON CHRISTY-BOX <br />COMPLETION <br /> Ground Stews <br />grout 4_ ft. <br />ft. <br />slotted <br />Becton <br /> SANOAQUIN <br />COUNTY <br />1/ Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 413 /11 Inspector: —v' <br />Facility Address: 12 ci cL„.1 <br />Well Address: <br />WP# 003g55,--? Well#: <br />Soil Boring#: <br />Drilling Company: V&1...) Or; V‘t kv <br />Driller Onsite: <br />Consultant: <br />Geologist: Geologist: ik-vvVizA,../ <br />Public Water System Onsite: LI Yes LINo <br />Domestic Well Onsite: El Yes El N o <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: CI Yes CI No <br />SPOILS <br />Contamination Noted: LI Yes 111 No <br />If yes, spoils storage Location: <br />Covered: CI Yes EINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 2.-5 <br />Depth to Water: U. -ft <br />Grout Material: v\eric <br />Gallons of of Grout Used: locc <br />DWell Installation M‘e-I 'l Destruction <br />111Boring Installation El Boring Destruction <br />METHOD USED <br />Pressure Grout TC<rer Drill <br />111 Gravity <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib I <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest #8585 <br />2.5 5 1 5 10 1 <br />s 10 2 10 20 2 <br />7.5 15 3 15 30 3 <br />10 20 4 20 ao 4 <br />12.5 25 s 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 />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 />04 6-5 tilt itto R oo 40 g c3 <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