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casing <br />height <br /> <br />C1-ER1STY-BOX <br />COMPLETION <br />Ground Surface <br /> <br />--ft A <br />slotted <br />imeclicn <br />gravel pack <br /> <br />ft. tt <br />grOUt <br />Min 2" Annular Seal Verified: <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION CI Stove Pipe <br />1s Ii1No .1 <br />From: 3D IJ1& To:121c-) 7e <br />From: Vg <br />From: Z6-) <br />From: O i <br />To: <br />tir y <br />To: <br />1 46.--17--istie Box <br />SAN JOAQUIN <br />— • <br />_41r.•••••0-,_ <br /> COUNTY-- <br />. Greatness <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />(-- Date: bA It/ Inspector: Lo---)( <br />Premise Address: its--4 r <br />WP#: 6031 43 <br />We11#: Vt,4 <br />Soil Boring#: <br />Drilling Company: INV All 6*-14 <br />Driller Onsite: <br />Public Water System Onsite: CI Yes CI No <br />Domestic Well Onsite: CI Yes CI NI o <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 111 Yes DNo <br />SPOILS <br />Contamination Noted: CI Yes EINo <br />If yes, spoils storage Location: <br />Covered: <br />GROUTING or DESTRUCTION Total Depth: 4-7f1,41 7.744 <br />Grout Material: At,* eivp—cA* <br />Depth to Water:_z3 V <br />If yes, material: <br />Co <br />Gallons of Grout Used: — 75S1 <br />&L,‘I Installation ClWell Destruction <br />E Boring Installation CI Boring Destruction <br />METHOD USED <br />LII Pressure Grout ClOver Drill <br />1ravity L1mie ClOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest flags Thickest Thinnest flags <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 s <br />15 30 6 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />CONSTRUCTION PtX <br />MATERIALS/DEVELOPMENT <br />Casing Type: hc.. 17-e-exa 04- <br />Blank 30 0 Feet Screen 5' IS Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: 4 L'Sb (i6) loj Ltov(la) <br />Type/Brand of Bentonite: Sc Lb I 61 ki,k <br />Filter Pack Type/Size: -r" etu <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 />tf too CAf, <br />1120 I <br />Consultant: <br />Geologist: <br />1=1 Yes E N o <br />.7 Total Depth: N 1 .14: <br />Drilling Rig Type: IA \u..-1 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com