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casing <br />height <br />CI-CRISTY-EIOX <br />COMPLETION <br />Ground Surface <br />grout <br />tt <br />to <br />eoned <br />moclon <br />gravel pack <br /> rt. ft. <br />—COUNTY----- <br /> Environmental Health Department SANAOAQUIN <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 'VP/ft Inspector: .4143 E-ers4,4- <br />F a cility Address: 4.5%?.? ?A( . <br />Well Address: <br />WP# 3? 5b/ Well#: <br />Soil Boring#:Bk //, )2y/3 iy,irdA. <br />Drilling Company: 14.40.1oAkeet <br />Driller Onsite: Pqw- <br />Consultant: 7Qtrtitinkr f?/,"4.e..es•-• <br />Geologist: frt 71r , t <br />Public Water System Onsite: El Yes No <br />Domestic Well Onsite: El Yes No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: El Yes El No <br />SPOILS <br />Contamination Noted: El Yes El No <br />If yes, spoils storage Location: <br />Covered: E Yes EN° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 51 <br />Depth to Water: vh <br />Grout Material: it.Aotil Cfat <br />Gallons of Grout Used: 04.4.0 <br />EWell Installation LI Well Destruction <br />OBoring InstallationXBoring Destruction <br />METHOD USED <br />li1Pressure Grout ElOver Drill <br />El Gravity <br /> <br />DTremie N.Other: -ewe 6a-t <br />Water <br />gallons <br />cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <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 />75 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 />Min 2" Annular EHD Seal Verified: El Yes li1No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION El Stove Pipe EChristie Box <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: <br />Drilling Rig Type: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com