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SAN JOAQUIN <br />COUNTY <br />Greatness grows here. <br />COMPLETION El Stove Pipe DChristie Box <br />casing <br />height <br />ABOVE-GROUND <br />COMPLETION <br /> <br />CHRISTY-SOX <br />COMPLETION <br />Ground Sudan <br />Environmental Health Department <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Monitoring Well/Soil <br />Date:'3/1 )/2 I Inspector: p-r-- 1:),- A. <br />Facility Address:'--50 4< 61____Dar40 <br />Well Address: <br />WP#00 46-1- Well#: <br />Soil Boring#: 61A2 /5 --3 <br />Drilling Company: core_ -T-14,.; n 1 I 45s,96/00 in 2- Annular EHD Seal Verified: <br />Driller Onsite:`Tcreen Length From: <br />Consultant: --1- 6R c.e.o+talivc.,04 Ty, L. , Filter Pack From: <br />/ <br />Geologist: K01,0P.4--+ Bentonite From: <br />Grout From: <br />Yes IIINo <br />To: <br />To: <br />To: <br />To: <br />Public Water System Onsite: 0 Yes li1No <br />Domestic Well Onsite: Li Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: LI Yes 0No <br />SPOILS <br />Contamination Noted: LI Yes 0No <br />If yes, spoils storage Location: <br />Covered: LI Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Tot9I Depth: <br />Depth to Water: 12— IS (-I- <br />Grout Material: N4+ conitp-‘, <br />Gallons of Grout Used: (•-- <br />DWell Installation LIWell Destruction <br />EBoring Installationoring Destruction <br />METHOD USED <br />Ii1Pressure Grout 0Over Drill <br />Gravity *remie DOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cementlt <br />Bags <br />...„) <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 <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 />fi.1- clot/ b/ <br />6VS ) <br />03:iS 1 <br />Screen Feet <br />60 ()Ckl\ g k) s <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 2000 468-3420 I F 209 464-0138 I www.sicehd.com <br />10/16/2017