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ABOVE-GROUND <br />COMPLETION <br />SAN ,JOAQUIN _ COUNTY <br />\ s•cs,i0,00` Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 3//671.0;/ Inspector: A//sc-0-.4.-- <br />Facility Address: /4 4) ,Z-sioAs7,u-( Del'eg <br />Well Address: <br />WP# 00 '// 79 We11#: <br />Soil Boring#: CPT-) <br />Drilling Company: 44,e4//e ette ,‘ <br />Driller Onsite: ct <br />Consultant: ce,"0,16,,e <br />Geologist: Af ,9 <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes ON° <br />To: <br />To: <br />To: <br />To: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />Public Water System Onsite: CI Yes El No COMPLETION El Stove Pipe 111Christie Box <br /> <br />Domestic Well Onsite: 0 Yes CI No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes EINo <br />SPOILS <br />Contamination Noted: CI Yes 0No <br />If yes, spoils storage Location: <br />Covered: 0 Yes El No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: /40' <br />Depth to Water: 21 <br />Grout Material: ivf.ife-ceAc sve- <br />Gallons of Grout Used: <br />0 Well Installation 0Well Destruction <br />LIBoring Installation Aoring Destruction <br />METHOD USED <br />IIIPressure Grout 1110ver Drill <br />0 Gravity Rremie 1110ther: <br />allonsp <br />( <br />Bi <br />C efe <br />_ s <br />47 I b Water <br /> gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest <br />-,... <br />/*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 e 40 80 8 <br />casing <br />height <br />CHR/STY-BOX <br />COMPLETION <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 />471 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com