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ABOVE-GROUND <br />COMPLETION <br />casing <br />height <br />Ground Surfacs <br />SAN JOAQUIN <br />, L. COUNTY - <br />Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: io-ZO--U Inspector: AA-stion... <br />Facility Address: '1 7$ 14.2 • yeAseme Ifir‘g <br />Well Address: <br />WP# (f7_4 53 Well#: <br />Soil Boring#: 41, <br />Drilling Company: __Ca( frire.1 <br />Driller Onsite: C--futor <br />Consultant: 9ve....104, 6.e0 eee-a.1-1-p.e.r <br />Geologist: .62cIrptg <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes GINo <br />To: <br />To: <br />To: <br />To: <br />Screen Length From: <br />Filter Pack <br /> <br />From: <br />Bentonite From: <br />Grout <br /> <br />From: <br />Public Water System Onsite: LI Yes COMPLETION LI Stove Pipe OChristie Box <br /> <br />Domestic Well Onsite: LI Yes ON° <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br /> El Yes 111No <br />SPOILS <br />Contamination Noted: Yes <br />If yes, spoils storage Location: <br />Covered: El Yes 111No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: 6'— <br />ft. Depth to Water: <br />Grout Material: p.A.ceeteceAfwe <br />Gallons of Grout Used: <br />ON° <br />slcned <br />victon <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />OWell Installation OWell Destruction <br />OBoring Installation rgrBoring Destruction <br />METHOD USED <br />OPressure Grout lilOver Drill <br />O-Gravity <br /> dTremie 00ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <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 />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 />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 />./c7 -tto"14'- Er i E6 w7=1001- <br />„y2,44- V /44,9e- <br />10/16/2017 z. Otis <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com