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COMPLETION 111 Stove Pipe <br />casing <br />height <br />0Christie Box <br />CHRISTY-BOX <br />COMPLETION <br />SAN JOAQUIN <br />COUNTY <br />Environmen._, Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: <br /> <br />Inspector: <br />cLe-Lc <br />CONSTRUCTION <br />Facility Address: <br />Well Address: <br /> <br />Total Depth: <br /> <br /> -CX\f, a_Drilling Rig Type: <br />Min 2" Annular END Seal Verified: 0 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />WP# er -a3i 7 7 4v <br />Soil Boring#: <br />Drilling Company: v A vi <br />Driller Onsite: <br />Consultant: (Tvau—.4 2-4.-0 <br />Geologist: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />Public Water System Onsite: 111 Yes <br /> <br />0No <br />Domestic Well Onsite: 0 Yes LINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 111 Yes ON° <br />SPOILS <br />Contamination Noted: El Yes EINo <br />If yes, spoils storage Location: <br />Covered: 111 Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: tA.„.....43- <br />Gallons of Grout Used: 1"/ (705 '2 701 <br />0Well Installation eII Destruction <br />LII Boring Installation El Boring Destruction <br />METHOD USED <br />ElPressure Grout leKer Drill <br />LI Gravity <br /> Lfmie ElOther: <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 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 />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 />10/16/2017 <br />/ I/ <br />1868 E. Hazelton Avenu'e I Stockton, California-52O5 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com