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COMPLETION El Stove Pipe LIChristie Box <br />5,, <br /> <br />casing IT height <br />CHR1S1-Y-BOX <br />COMPLETiON <br />11 <br />ABOVE-GROUND <br />COMPLETION <br />SANAOAQUIN <br />C.U; COUNTY <br />'it•-•`- „reatness grows here. <br />Environmer Health Department <br />Monitoring We Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />W P# 00 -2•34% (g?t 0 Well#: Drilling Rig Type: <br />Date: Inspector:larMi 36A <br />Facility Address: El s i>r - <br />Well Address: <br />, CA-1S Cy- , CHSG-.3 C4-1S6,74 Soil Boring#: CI4SC-/— I _Iii4;try‘..ia. Min 2” Annular EHD Seal Verified: <br />Drilling Company:-TE(/ K)c)(4-ks-Artet <br />Driller Onsite Cra.i Screen Length From: <br />Filter Pack From: Consultant: WM 10C.C. ie..t.4..k I 2. <br />Bentonite From: <br />Grout From: <br />Geologist: JOC SeA,Lbr-rel <br />Public Water System Onsite: El Yes EN° <br />Domestic Well Onsite: LI Yes LINo <br />If yes, location and distance: <br />EIlYes 111No <br />To: <br />To: <br />To: <br />To: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location: <br />LIlYes ENo <br />LI Yes IEINo <br /> <br />Covered: <br />If yes, material: <br />Yes ENo <br /> <br />GROUTING or DESTRUCTION Total Depth:5 1 , <br />Depth to Water: o vu2_ <br /> r <br />viva-f cimbvt. Grout Material: <br />Gallons of Grout Used:I/2 10, 1/ , 10 <br />III Well Installation El Well Destruction <br />111Boring Installation oring Destruction <br />METHOD USED <br />OPressure Grout 1110ver Drill <br />El Gravity ETremie ther: -1{ep irck /I <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest # Bags <br />' 2.5 5 1 s 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 wvvw.sioehd.com