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SAN JOAQUIN <br />COUNTY <br />Environmental Health Department ..6:16111. <br />Greatness grows here. <br />ABOVE-GROUND <br />COMPLETION <br />Monitoring Well/Soil Boring Inspection Report <br />Date: -7-3**XZ Inspector: AA'ste-6*- <br />Facility Address: 1Z40 gun. vto <br />Well Address: <br />WP# Q 4'30 4 Well#: <br />Soil Boring#: 1,114 <br />Drilling Company: Ceine+ec <br />Driller Onsite: M <br />Consultant: i+c.41.4 .1 A--1c1 <br />Geologist: cree . <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes EINo <br />From: To: <br />From: To: <br />From: To: <br />From: To: <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />Public Water System Onsite: 0 Yes 0 N o COMPLETION 0 Stove Pipe EIChristie Box <br /> <br />Domestic Well Onsite: 0 Yes ENo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />casing <br />height <br />CHRISTY-80X <br />COMPLETION <br />C3roUrgi Surfacs <br />Screening Method: <br />Verified Chain of Custody: CI Yes 0No <br />SPOILS <br />Contamination Noted: 0 Yes No <br />If yes, spoils storage Location: <br />Covered: 0 Yes EN° <br />If yes, material: <br />GROUTING or DESTRyCTION Total Depth: <br />Depth to Water: 6 <br /> 6,0 1 <br />Grout Material: tjvc,t 4-- court.ow. <br />Gallons of Grout Used: 9 eAtko...s <br />OWell Installation 0 Well Destruction <br />Boring Installation R 'Boring Destruction <br />METHOD USED <br />0Pressure Grout 00ver Drill <br />Gravity 4Tremie E0ther: <br />Water <br />gallons <br />Cennent471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest //Bags Thickest Thinnest :nags <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 />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 />-ft <br />slotted <br />secdon <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com