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Greutfiess yrows heir. <br />COUNTY <br />-.49.Foce <br />SAN JOAQUIN Environmental Health Department <br />casing <br />height <br />CHRISTY-BOX <br />COMPLETION <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: 0 Yes 0No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 0 Stove Pipe 0Christie Box <br />Gourd Surf aca <br />grout <br />ft <br />ft. <br />_ft <br />slotted <br />strolon <br />1 ' /26 i 25 ft. ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 'il.' Inspector:— <br />Facility Address <br />Well Addres <br />WP# 0 tAr Ci-(0 Well#: <br />Soil Boring#: Vi —'ZD Cm —6) <br />Drilling Company: \JAW <br />Driller Onsite: Anikpoo A 1'"r6k0A4-1 , <br />Consultant: C%,*-6 CDI\ <br />Geologist: icy&cdfo <br />Public Water System Onsite: 0 Yes ENo <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 0No <br />SPOILS <br />Contamination Noted: El Yes El N o <br />If yes, spoils storage Location: <br />Covered: 111 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />) (24 551 "Y5-) 551 55 <br />Grout Material: ?fleet+ <br />11‘'L <br />Water <br />gallons <br />C ent 47Ib <br />Bags ,..„., <br />/ Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest ' , gs Thickest Thinnest 4 Bags <br />2.5 51 5 10 1 <br />5 10 2 10 20 2 <br />7.5 15 3 <br />1 <br />15 30 a <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 4 40 80 8 <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 />Gallons of Grout Used: <br />0Well Installation OWell Destruction <br />111Boring Installation V. toring Destruction <br />METHOD USED <br />0Pressure Grout 00ver Drill <br />FGravity Arremie E0ther: <br />P <br />CONSTRUCTION <br />Actil titt14 0/0.-lij . <br />Total Depth: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com