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COMPLETION 0 Stove Pipe <br />casing <br />height <br />0Christie Box <br />c4-1iRis-ry-8ox ' <br />COMPLET19N <br />3 r t <br />ft. <br />SANdOAQUIr <br />(..)i_JNTY— <br />Grecytness grows here. <br />Environme I Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: z- ILu ector: dt•-• <br />—00fitc40" Facility A dres . <br />Well Address: 7-0 s• <br />wp# A/Paz) SZ Well#: <br />Driller Onsite: 1A-pc (-9/.19 e !C7reen Length From: <br />f0 Drilling Company: <br /> <br /> <br />) <br />"Annular EHD Seal Verified: Yes No 6Ce-P)') <br />H44 tf i( To: <br />Consultant: C 4jfuts 6:1"- Filter Pack From: To: <br /> <br />From: To: <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Soil Boring#: -1162 /7.0 /1 CP " ,D' _4,O'1, <br />Geologist: trx-u From: To: Bentonite <br />Grout <br />Public Water System Onsite: <br />Yes 0No <br />Domestic Well Onsite: <br />0 Yes 0No <br />If yes, location and distance: <br />Screening Method: <br />Verified Chain of Custody: <br />0 Yes ElNo <br />SPOILS <br />Contamination Noted: El Yes EINo <br />If yes, spoils storage Location: <br />I=1 Yes 0No <br />GROUTING or DESTRUCTION Total D9pth: /707 ,1V 7 <br />Depth to Water: 2-4/ <br />Grout Material: <br />Gallons of Grout Used: <br />0Well Installation OWell. Destruction <br />0Boring Installation Zring Destruction <br />METHOD USED <br />EPressure Grout 00ver Drill <br />0 Gravity Tremie 00ther: <br />Water <br />gallons <br />Cement 47 lb <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest #8ags <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 />SAMPLING <br />Holding Temperature: <br />Method: <br />Covered: <br />If yes, material: <br />-z, <br />1868 E. Hazelton Aen6e 1 ttockton, California 95205 T 209 468-3420 I F 209 464-0138 F. www.sicehd.com <br />10/16/2017