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casing <br />height <br />ABOVE. GROUND <br />OFLET ON CHRISTY49,0X <br />COMPLETION <br />Min 2" Annular EHD Seal V6ified: CI Yes ON° <br />COMPLETION ID Stove Pipe EChristie Box <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: To: <br />From: To: <br />From: To: <br />To: From: <br />LI Well Installation El Well Destruction <br />CI Boring Installation oring Destruction <br />METHOD USED <br />Li Pressure Grout DOver Drill <br />El Gravity Tremie DOther: <br /> <br />c '';!' ---r—`, =72. SANdOAQUIN l/0 Environmental Health Department : L-:....T.:..., ';—COUNTY <br />,-,As-_,f,7-/ it c,,. .'Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: e1/1 Inspector:90(1\i MIA CONSTRUCTION <br />Facility Address:10D 9 1 Alai <br />Well Address: Total Depth: <br />WP# Well#: Drilling Rig Type: <br />Soil Boring#: j goz. , too <br />Drilling Company: (r3;10.- <br />Driller Onsite: MC•le <br />Consultant: VIQWI <br />Geologist: <br />Public Water System Onsite: <br /> X(es LINo <br />Domestic Well Onsite: Yes No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes JNo ./ <br />SPOILS <br />Contamination Noted: lil Yes k No <br />If yes, spoils storage Location: <br />Covered: lil Yes t No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Used: OrS- &/-3<4.4,71.) <br />75- mr4tr &lon 6A4( <br />Casing Type: <br />MATERIALS/DEVELOPMENT <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 />Depth to Water: <br />Grout Material: <br />Gallons of Grout <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 C.1.5,2 15 30 3 <br />10 20 20 40 4 <br />12.5 25 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 />BentonitelCement 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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com