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casing <br />height <br />CHRISTY-80X . • <br />CONPLEnpN <br />Ground Surf aos <br />A SAN JOAQUIN Environmental Health Department , <br />Monitoring Well/Soil Boring Inspection Report <br />COUNTY <br />/ \\,,,r1 Greatness groLvs here. <br />11- 5 kon Date: Inspector: ur-to\scki <br />Facility Address: 1-44 t.\\ ,mkumne 'Qua <br />Well Address: 1-44 I\1 \\tuxvn-e_ <br />wP# (A).61.‘bbci Well#: <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Soil Boring#: I — <br />Drilling Company: SC‘‘CAri Q/rtre.einyll V k,uf \Rt., Min 2" Annular EHD Seal Verified: <br />Driller Onsite: Screen Length From: <br />Consultant: Filter Pack From: <br />Geologist: Bentonite From: <br />Grout From: <br />Public Water System Onsite: Eli Yes ONo COMPLETION LI Stove Pipe <br />Yes ONo <br />To: <br />To: <br />To: <br />To: <br />GI Christie Box <br />Domestic Well Onsite: LI Yes LINo <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes El No <br />SPOILS <br />Contamination Noted: CI Yes ONo <br />If yes, spoils storage Location: <br />Covered: EYes O No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: c') —2 S <br />Depth to Water: 0 q <br />Grout Material: cow\ <br />Gallons of Grout Used: <br />El Well Installation El Well Destruction <br />111Boring Installation Iiitt oring Destruction <br />METHOD USED <br />El Pressure Grout 00ver Drill <br />.Gravity OTrernie Other: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest <br />10 <br />4 Bags Thickest 1 <br />5 <br />Thinnest <br />10 <br /># Bags <br />1 <br />2 10 20 2 - C3 15 15 80 3 <br />3.0 <br />IF <br />5 <br />20 q 20 40 4 <br />2s 5 25 50 5 <br />-L e N (6) 30 60 6 <br />17.5 N 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 /2 017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com