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Min 2" Annular EHD Seal Verified: <br />Screen Length From: <br />Filter Pack From: <br />Bentonite From: <br />Grout From: <br />Yes 111 N o <br />To: <br />To: <br />To: <br />To: <br />ft. <br />COMPLETION El Stove Pipe EChristie Box <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />t3rouncl Surface <br />grout <br />slonAd <br />imcdon <br />ft. <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 />SAN JOAQUIN <br />COUNTY <br />Greatness gi.cms het c. <br />Date: 611 2 1 InspecSpr: Z(Vc53 <br />Facility Address: ) I <br />Well Address: <br />WP# OCA3 6 1 Well#: <br />Soil Boring: <br />Drilling Company: C-iret <br />Driller Onsite: <br />Consultant: \L\614--eoct4,1 <br />Geologist: <br />Public Water System Onsite: 111 Yes ID No <br />Domestic Well Onsite: <br /> <br />El Yes LIN0 <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes EINo <br />SPOILS <br />Contamination Noted: LI Yes liINo <br />If yes, spoils storage Location: <br />Covered: El Yes lilNo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: S-) <br />Depth to Water: 2, <br />Grout Material: N Q (.-I"%(-- <br />Gallons of Grout Used: <br />LI Well Installation LI Well Destruction <br />E] Boring Installation RBoring Destruction <br />METHOD USED <br />OPressure Grout ElOver Drill <br />1:1 Gravity EtTremie ElOther: <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 />Environmental Health Department <br />WAVou 4AVe&tor <br />Ott poi Pt-,S, <br />C-trotAtcl <br />Total Depth: <br />Drilling Rig Type: a.4 <br />CONSTRUCTION <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 />Monitoring Well/Soil Boring Inspection Report <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