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casing <br />height <br />CHFUSTY-BOX <br />COMPtETION <br />gravel pack <br />to. <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes 0No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 111 Stove Pipe CIChristie Box <br />Ground Surface <br />grail <br />4-- ft. <br /> ft <br />A ft <br />slotted <br />secdon <br />ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br /> SANJOAOUIN <br />''b11161 COUNTY <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Environmental Health Department <br />Date: t-tbi /L7 Inspector: )6,„ <br />Facility Address: 3 Jo <br />Well Address: <br />W P# 14/ lol" Well#: Si—i 1 Sit, <br />Soil Boring#: <br />Drilling Company: I 0 <br />Driller Onsite: <br />Consultant: <br />Geologist: Geologist: <br />Public Water System Onsite: 0 Yes 0No <br />Domestic Well Onsite: 0 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes EN° <br />SPOILS <br />Contamination Noted: 0 Yes 0No <br />If yes, spoils storage Location: <br />Covered: 0 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: _r <br />Depth to Water: C.) <br />Grout Material: 6.,e,..4r <br />Gallons of Grout Used: 4, <br />0Well Installation eII Destruction <br />EBoring Installation 0Boring Destruction <br />METHOD USED <br />EPressure Grout 06er Drill <br />E Gravity 0Tremie 00ther: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest 4 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 1 209 468-3420 F 209 464-0138 I www.sicehd.com