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SANJOAQUIN f14°) —COUNTY--- <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Environmental Health Department <br />Date: 021 2.6121 Inspector: SCk. <br />Facility Address 1(600J3. &War* LANZ, <br />Well Address: <br />vv P# DO 41 9.(Y-A Well#: <br />Soil Boring#: CP T-4'rl <br />Drilling Company: ecieTh Cleb ICS+i(1911x <br />Driller Onsite: <br />Consultant: b\L 1:112tsepociai-es <br />pic) b <br />Geologist: Omar IL, Khan. <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes 0No <br />Screen Length From: To: <br />Filter Pack <br /> <br />From: To: <br />Bentonite From: To: <br />Grout <br />From: To: <br />Public Water System Onsite: El Yes DNo COMPLETION 0 Stove Pipe 0Christie Box <br /> <br />Domestic Well Onsite: CI Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Verified Chain of Custody: D Yes 111No <br />SPOILS <br />Contamination Noted: El Yes ILINo s/V\ d'ct"r• <br />If yes, spoils storage Location: <br />0 Yes LIN° <br />GROUTING or DESTRUCTION Total Depth: 50 Pr <br />Depth to Water: <br />Screening Method: <br />Covered: <br />If yes, material: <br />casing <br />height <br />ABOVE-GROUND <br />C:0 MPLETION <br /> <br />CHRISTY-130X <br />COMPLETION <br />Grout Material: N.Ave.,ft‘' <br />Gallons of Grout Used: e'-'15-6e1 . <br />111 Well Installation 111Well Destruction <br />El Boring InstallationYiBoring Destruction <br />METHOD USED <br />0Pressure Grout 0Over Drill <br />111 Gravity itaTremie DOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gall ons <br />Cement 94W <br />Bags <br />Thickest Thinnest a 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 s 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 />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