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OChristie Box COMPLETION 0 Stove Pipe <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes EINo <br />To: <br />To: <br />To: <br />To: <br />casing <br />height <br />CliiRISTY-BOX <br />COMPLETION <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />SAN JOAQUIN <br />COUNTY <br />Greatness grows here <br />Environmer ' Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: t7_ /T A M Inspector: <br />Facility Address: I ViD Veevi <br />Well Address: il.111 <br />WP# 00Y/6 IA Well#: tiNio w <br />Soil Boring#: <br />Drilling Company: Vcs,I,J <br />Driller Onsite: aevvv,--;..77, <br />Consultant: C1-6 14"-4 <br />Geologist: Prn-ekisit.A.i Lbtv-v1 <br />Public Water System Onsite: El Yes IIINo <br />Domestic Well Onsite: LI Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: Yes El No <br />SPOILS <br />Contamination Noted: 0 Yes EN° <br />If yes, spoils storage Location: <br />Covered: EYes El No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: _N-1 z z <br />Depth to Water: <br />Grout Material: (\ e..1.4 <br />Gallons of Grout Used: Iv <br />-1-14 <br />LI Well Installation id Well Destruction <br />El Boring Installation LII Boring Destruction <br />METHOD USED <br />111Pressure Grout 1110ver Drill <br />Er&avity ETremie <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 94th <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest tl 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 />CONSTRUCTION <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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com