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COMPLETION 0 Stove Pipe D Christie Box <br />casing <br />1—f— height <br />ABOVE-GROUND <br />COMPLETION cmsri-Box - <br />comptErioN . . . Grochx1 Surta4-• <br />ft_ <br />ft- <br />ft. <br />skatad <br />seclon <br />;rival pack <br />Y IL <br />1 SANdOAQUIN <br />COUNTY / <br />Drilling Company: &y-e Dr1 iteNcls <br />Driller Onsite: Lee <br />Consultant: <br />Geologist: <br />Domestic Well Onsite: <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br />0 Yes 0No <br />SPOILS <br />Contamination Noted: El Yes ENo <br />If yes, spoils storage Location: <br />Covered: 1=I Yes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: t 51, S' <br />Depth to Water: VI Vt_g_ <br />Grout Material: MA+ CiArvvitAAA- <br />Gallons of Grout Used: 5 5 J <br />OWell Installation OWell.Destruction <br />0Boring InstallationAoring Destruction <br />METHOD USED <br />Li Pressure Grout 0Over Drill <br />0 Gravity 0Tremie '5Zother: ilree 41 I <br />Water <br />gallons <br />cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest 'Bags Thickest Thinnest g Bags <br />2.5 5 1 s 10 1 <br />5 10 2 10 20 2 <br />7.5 15 3 15 30 8 <br />10 20 4 20 40 4 <br />12.5 25 5 25 SO s <br />15 30 6 • 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 40 80 8 <br />Environme , Health Department <br />YI <br />i <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank 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 />To GI etnvl <br />Public Water System Onsite: 0 Yes ON° <br />0 Yes 0No <br />ze• Greatness grows here. <br />Monitoring Well/Soil Boring Inspection Report <br />Date: I Inspector: P.) iv/I./l a:WI I Y\XL... <br />Facility Address: -3-11 S Ici Ave. <br />Well Address: <br />WP# 005 ( 3'1 Well#: <br />Soil Boring#: 5G-0 5 5C7 -06 , 66, •-o- <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br />From: <br />Screen Feet <br />10/16/2017 <br />1868 E. Hazelton Avenue l Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.sicehd.com