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EChristie Box COMPLETION CI Stove Pipe <br />casing <br />height <br />CHPUSTY-BOX <br />COMPLETION <br />Ground Surfacs <br />SAN10AQUIN () —COUNTY <br />cAS2er,r/ Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Inspect r a-kki <br />Facility A dr ss: <br />Well Address: <br />WP# CbLi ill <br />Soil Boring#: <br />Drilling Company: 1,A)(25)—(ea cj+ Scp <br />Driller Onsite: <br />Consultant: L.,_t CciA ce. <br />Geologist: ci-alr'Ve, SinCL. 10001 <br />Min 2" Annular EHD Seal Verified: <br /> <br />1°' Tit • Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />El Yes ON° <br />To: <br />To: <br />To: <br />To: <br />coo CONSTRUCTION <br />. <br />Total Depth: <br />Drilling Rig Type: Well#: <br />Public Water System Onsite: LIlYes ON° <br />Domestic Well Onsite: Yes EINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes El N o <br />SPOILS <br />Contamination Noted: El Yes ElNo <br />If yes, spoils storage Location: <br />Covered: 1=1 Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: v).3.2,1 • <br />Grout Material: <br /> 1\\ Eck \- CiPloelf \.V • <br />Gallons of Grout Used: e . <br />El Well Installation LII Well Destruction <br />El Boring Installation .3k.Boring Destruction <br />METHOD USED <br />Pressure Grout DOver Drill <br />X Gravity ITremie DOther <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest /*Bags Thickest Thinnest 8 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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com