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CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: H I la <br />Min 2" Annular EHD Seal Verified: <br />Screen Length From: ,,A) <br />Filter Pack From: 4'5- <br />Bentonite From: LI 1— <br />Grout From: <br />COMPLETION LI Stove Pipe <br />s I=1No <br />To: <br />To: jçT <br />To: Go`A-5 <br />To: 11- <br />11eh'ristie Box <br />MATERIALS/DEVELOPMENT <br />Casing Type: $c_ k 46 P <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: GtvtioS <br />Filter Pack Type/Size: <br />Type of Method: <br />n <br />casing <br />height <br /> <br />CKRISTY-BOX <br />COMPLETION <br />Ground Surfacs <br />SANAOAQUIN 1.1.614) COUNTY <br />Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Vi_t/G5 Inspector: <br />Facility Address: 32;7 7:7 e‘,„,4 J-1 41f <br />Well Address: <br />vvp# co 71,6v-14 Well#: <br />Soil Boring#: <br />Drilling Company:1%4.e <br />Driller Onsite:'— <br />Consultant: <br />Geologist: L,L ic-c Pagyvvi <br />Public Water System Onsite: 0 Yes 0 No <br />Domestic Well Onsite: 0 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes 0 No <br />SPOILS <br />Contamination Noted: Yes 0No <br />If yes, spoils storage Location: <br />Covered: 0 Yes No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: tit <br />Depth to Water: 0 <br />Grout Material: AAA* <br />Gallons of Grout Used: kW 4-1 .-7t to j— c) <br />VIV<II Installation 0Well Destruction <br />E Boring Installation El Boring Destruction <br />METHOD USED <br />0Pressure Grout 0Over Drill <br />0 Gravity <br />&I"Trernie 0Other: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest 4 Bags Thickest Thinnest 4 Bags <br />2.5 5 1 5 10 1 <br />5 10 2 10 20 1 <br />TS 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 />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 />ko tint / ft,1,0 tti IL / 10 4' 14.1,0 3 411.6 4. I ql tip <br />1868 E. Hazelton Ayenuec? Stockton, California 95205 I T 269 468-3420 I F 209 464-0138 I www.sjceh'd.com