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\ SAN JOAQUIN a: COUNTY <br />,r,flH.SS gr . <br />Environmental Health Department <br />0 Stove Pipe COMPLETION E Christie Box 0 Yes IX10 Public Water System Onsite: <br />0 Yes tklo <br />Verified Chain of Custody: <br /> El Yes 0No <br />SPOILS <br />Contamination Noted: <br />Covered: 0 Yes No <br />Depth to Water: <br />GROUTING or DESTRUCTION Total Depth: <br /> <br />Ake's.< C-fatto.f <br />Gallons of Grout Used: k <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 14 Inspector: 5.&71/ <br />Facility d ress: O ?Agapt.re <br />Well Address: If <br />WP# 6D cl- 27, 2, I Well#: _Cgr_I <br />Soil Bonn #: <br />Drilling Company: &Q:, ,- EAC <br />Driller Onsite: A/ICC <br />CONSTRUCTION <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 />Consultant: <br />Geologist: <br />Domestic Well Onsite: 111 Yes No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />If yes, spoils storage Location: <br />If yes, material: <br />LII Well Installation 0Well Destruction <br />E Boring Installation 1*.oring Destruction <br />METHOD USED <br />EPressure Grout 00ver Drill <br />CI Gravity *remie 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 #Bags <br />2.5 5 1 5 10 1 <br />5 10 10 20 2 <br />7.5 . r2 )n <br />15 30 3 <br />10 0 Cei 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 />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />_tt <br />stoned <br />soction <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 />Grout Material: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />ABOVE-GROUND <br />COMPLETION <br />From: <br />From: <br />From: <br />From: