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COMPLETION El Stove Pipe <br />casing <br />height <br />El Christie Box <br />crisisri,-pox - <br />COMPLEnpN <br />SAN JOAQUIN <br />COUNTY <br />r-. <br />Environmen....1 Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 7 I 2.1 I X Inspector: a,- Ytt, <br />Facility Address: IT.94,,c <br />Well Address: Address: <br />WP# 04 .3-1 Well#: MV4 <br />Soil Boring#: <br />Drilling Company: VA Oft <br />Driller Onsite: flrek„Aa koc.. <br />Consultant: <br />Geologist: <br />Public Water System Onsite: 111 Yes 111No <br />Domestic Well Onsite: 111 Yes ElNo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes ONo <br />SPOILS <br />Contamination Noted: El Yes El No <br />If yes, spoils storage Location: <br />Covered: 111 Yes LINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 3SA <br />Depth to Water: V2-4 <br />Grout Material: r\ ert GeAANA"AS— <br />Gallons of Grout Used: V <br />EWeIl Installation 16/Well Destruction <br />El Boring Installation DBoring Destruction <br />METHOD USED <br />El Pressure Grout DOver Drill <br />111 Gravity remie 1110ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <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 6 40 80 8 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: D Yes DNo <br />Screen Length From: To: <br />Filter Pack From: To: <br />Bentonite From: To: <br />Grout From: To: <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 />7—"rO <br />10/16/2017 <br />1a <br />I i Lin iL int% (dA 11 <br />1868 E. Hazelton Avenue I Stockton, liror2 950 T 209 468-3420 I F 209 464-0138 I www.sioehd.com