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casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHRISTY-BOX <br />COMPLETION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: LI Yes 111No <br />To: <br />To: <br />To: <br />To: <br />CI Stove Pipe LIChristie Box <br />Ground Surface <br />grout <br />ft <br /> ft <br />ft <br />slotted <br />soc-don <br />gravel pack <br />tt ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />From: <br />From: <br />From: <br />From: <br />SANAOAQUIN <br />COUNTY <br /> Environmental Health Department <br />Greatness 9rows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Inspector: <br />Facility Address: tu t r -.Crt <br />Well Address: <br />WP# 0_,VjAM.-/ Well#: <br />Soil Boring#: p I 4)-6 <br />Drilling Company: 06751 <br />Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: 0 Yes <br /> ON° <br />Domestic Well Onsite: 0 Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br /> <br />El Yes 0 No <br />SPOILS <br />Contamination Noted: LI Yes ON° <br />If yes, spoils storage Location: <br />Covered: CI Yes E N o <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: Zo pt- <br />Depth to Water: (; <br />Grout Material: (1.6t1S CiAvv--) <br />Gallons of Grout Used: — <br />‘IP ) <br />ElWell Installation Eli Well Destruction <br />0 Boring Installation 11.8c -ing Destruction <br />METHOD USED <br />ElPressure Grout 1110ver Drill <br />CI Gravity EfTremie 1110ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # 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 />CONSTRUCTION <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 />7eutA <br />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 www.sicehd.com