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casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHRISTY-BOX <br />COMPLETION <br />Min 2" Annular EHD Seal Verified: <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />COMPLETION LI Stove Pipe <br />0 Yes LINo <br />To: <br />To: <br />To: <br />To: <br />0Christie Box <br />Gtwnd Surtac s <br />ft -- <br />slotted <br />aacdon <br />gravel pa::k <br /> it ft. <br />CI Gravity ?6-Tremie 13C0—ther: <br />Water <br />gallons <br />Cement k.7.2.lo Water <br />gallons <br />Cement 941b <br />Bags Bags <br />Thickest Thinnest # Bags 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 5 <br />15 30 6 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />LIBoring Installation 0Boring Destruction <br />METHOD USED <br />0Pressure Grout KOver Drill <br />SAICJOAQUIN <br />---COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Li/2- qfrii Inspector: <br />Facility Address: 0,-‘..e....-- <br />wp#00 4 f ytlf--2__S ' Well#: VM-0 <br />Well Address: &PT #..,&r&Kt_ <br />Soil Boring#: <br />Drilling Company: <br />Driller Onsite: Onsite: 171,1,; 1 <br />Consultant: <br />Geologist: <br />Public Water System Onsite: 0 Yes 0No <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 0No <br />SPOILS <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: LI Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 95 El <br />Depth to Water: ^-111-1 <br />Grout Material: <br />Gallons of Grout Used: <br />Li Well Installation <br />Total Depth: <br />Drilling Rig Type: <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />CONSTRUCTION <br /> <br />a/n-,e77L-{- <br />-323.0)0-1 <br />ell Destruction Screen Feet <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 />kss iktuy. L" 04-10 0,4- teri <br />1A-11-11 1; Ptir l a'1± <br />114c <br />a 0/16/2017 ciqtA,K. at-i...011 5volt-to_ -kJ—a <br /> <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464=t1138 Iwww.sicehd.com 21