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Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes EINo <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 0 Stove Pipe <br />casing <br />height <br />0Christie Box <br />CHRISTY-BOX <br />COMPLETION <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />SAN JOAQUIN <br />COUNTY <br />GreCii.:E.SS qr.), <br />Environment., Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: P71.1/F Inspector: <br />Facility Address: Pt IS <br />Well Address: <br />WP# 3gesTa <br />Soil Boring#: <br />Drilling Company: VZ Li Dr <br />Driller Onsite: Cr.^ v./I< <br />Consultant: Cp-p-0 1.4 ,47( <br />Geologist: <br />Public Water System Onsite: 0 Yes EINo <br />Domestic Well Onsite: El Yes EINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: Yes 0 No <br />SPOILS <br />Contamination Noted: 0 Yes ENo <br />If yes, spoils storage Location: <br />Covered: El Yes DNo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: (2- 4- <br />Grout Material: vt,e_Ait" <br />Gallons of Grout Usedr-Yal 1-8-01 <br />DWell Installation ell Destruction <br />0Boring Installation 0Boring Destruction <br />METHOD USED <br />111Pressure Grout ar Drill <br />CI Gravity <br />11-7{-ernie ClOther: <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 />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 />Well#: (7-e 1 16tot. <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 l F 209 464-0138 I www.sjcehd.com