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casing <br />height <br />CHRISIY-BOX <br />COMPLE119N <br />SANAAQUIN <br />COUNTY <br />Greatness grows here. <br />(47/0\xAsii rrTg <br />Well/Soil <br />Date: \-\\1,Art.k Inspector: ak51,9.,\_ <br />Facility Address: C1C) r‘viScc.4-.CejkPA <br />Well Address: c;•/- <br />WP# \\c\c) We11#: — <br />Soil Boring#: <br />Drilling Company: P,cbt--- \..1F,..0%.1frc\-) <br />Driller Onsite: <br />Consultant: t <br />Geologist: <br />Public Water System Onsite: ▪ Yes VNo <br />Domestic Well Onsite: <br /> <br />• Yes No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: LII Yes EINo <br />SPOILS <br />Contamination Noted: 0 Yes ONo <br />If yes, spoils storage Location: <br />Covered: LlYes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: u\kl- <br />Depth to Water: <br />Grout Material: 1,-) kikpx <br />Gallons of Grout Used: <br />Well Installation El Well Destruction <br />ClBoring Installation El Boring Destruction <br />METHOD USED <br />ElPressure Grout iilOver Drill <br />CI Gravity <br /> <br />iTremie ClOther: <br />Water <br />gallons <br />cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest g 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 />Environmental Health Department <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: `',°\'7-- <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: Z 'Yes li1No <br />SccLeri-Leit g ll, From: To: <br />• <br />Grout <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 />"Fitter-Park t-o1 /44---PcSrom: To: •-.V\-1_ <br />From: To: <br />From: To: <br />El Stove Pipe 0 Christie Box <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 I F 209 464-0138 I www.sicehd.com