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COMPLETION CI Stove Pipe IiIChristie Box <br />Grcx.irkl Surfacs <br />vow <br />41. <br />ft <br />ft <br />tt <br />ft <br />casing IT— height <br />CHRISTY-BOX <br />ccmpt_ErioN <br />ABOVE-GROUND <br />cow:IS-not:4 <br />siorard <br />sacjon <br />Jr <br />NAOAQUIN <br />—COUNTY--- <br />Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date:7/5 I Inspector: &I/unit/1i yk.e.. 4 CONSTRUCTION <br />- r <br />Facility Ad ress: sao 3, Ary-Le.v-ircay. s-1-.. <br />Well Address: Total Depth: <br />wP# 003511S-1- Well#: <br />Soil Boring#: &3 GB-4-1 C13 .-./ C•-- i C76--3-Min 2" Annular EHD Seal Verified: : C7e,oc-ov_ Drilling Compan <br />Driller Onsite: <br />Consultant: <br />Geologist: Mic.bie - <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />Environme.I Health Department <br />(7 —7 irt7-td <br />o <br />Drilling Rig Type: <br />LI Yes LIN° <br />To: <br />To: <br />To: <br />To: <br />Public Water System Onsite: <br /> <br />El Yes lilNo <br />Domestic Well Onsite: III Yes 111No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes ON° <br />SPOILS <br />Contamination Noted: LI Yes ON° <br />If yes, spoils storage Location: <br />Covered: LIYes lilNo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth:5'6 61 Co 112 <br />Depth to Water: YVOKLL- <br />Grout Material: I'D2Ctri <br />Gallons of Grout Used:3)33„;31/1 i'._ <br />El Well Installation OWell.Destruction <br />OBoring Installation Boring Destruction <br />METHOD USED <br />11Pressure Grout DOver Drill <br />Water <br />gallons <br />Cernent47113' '4 / <br />Bag.s.„.../ <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest Thickest Thinnest 8Bags —1313-ags <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 AO 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 1 209 468-3420 j F 209 464-0138 I www.sicehd.com