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To: <br />To: <br />To: <br />To: <br />From: <br />From: <br />From: <br />From: <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION LI Stove Pipe <br />casing <br />height <br />CHRISTY-WX <br />COMPLE119N <br />lilChristie Box <br />SAN JOAQUIN <br />COUNTY-- <br />Environmen, Health Department <br />s \oala",7N- oreatness grows her. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 1) Inspector: L., <br />Facility Address: 7.-ADS:--7 S • <br />Well Address: 241g— 5So ,s <br />WP# fl (47 Well#: <br />Soil Boring#: CC-CS- — 2-4) '4/0 Isg6t 81 <br />Drilling Company: Cr-re-5 di' <br /> <br />. S Driller Onsite: <br />Consultant: <br />Geologist: <br />Public Water System Onsite: El Yes Ii1No <br />Domestic Well Onsite: CI 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 111No <br />SPOILS <br />Contamination Noted: El Yes EN° <br />If yes, spoils storage Location: <br />Covered: El Yes EN° <br />If yes, material: <br />GROUTING or DESTRUCTION <br />Depth to Water: IL <br />Grout Material: (1-e•A" <br />Gallons of Grout Used: le5 1 12), 14)) tl." <br />LI Well Installation LIWell Destruction <br />El Boring Installation Rioring Destruction <br />METHOD USED <br />El Pressure Grout lilOver Drill <br />H"-G---ravity Liie 1E10ther: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cernent94Ib <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 />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: LI Yes ON° <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 />Total Depth: 2-yrc ibs,ii <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209468-34201 F 209 464-0138 1 www.sicehd.com