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CONSTRUCTION <br />Total Depth: 501 <br />Drilling Rig Type: t'k 014-014) *ZIA /L J4( <br />Min 2" Annular EHD Seal Verified: <br />Screen Length From: -2/7 <br />Filter Pack From: S12 <br />AlYes 0 No <br />To: <br />To: <br /> <br />Bentonite From: t To: -t <br />Domestic Well Onsite: casing <br />height <br />Yes <br />If yes, location and distance: <br />Gaxind Surfacs <br />CHAMTY-BOX <br />COMPLETION <br />SAMPLING <br />Holding Temperature: <br />Method: <br />-"-k SAN JOAQUIN <br />i. —COUNTY <br />I cr,01, Greatness grows here 4, <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 1 Inspector: tr t,‘Ak Cr L r44*t <br />Facility ddressTt-/ C01,4,4A-1 (AAA') 151 .1? <br />Well Address: 7J. LytA,vvkvvi Uut b <br />WP# 5A-6i3 1- Ev.> <br />Soil Boring#: r LA) <br />Drilling Company: t1 tso,c,tt ovviloy‘m-totit <br />Driller Onsite: t1,42 ‘• <br />Consultant: Cr <br />Geologist: t3cv. i‘/GliktAAA <br />Grout <br /> <br />From: To: 0 <br />Public Water System Onsite: 0 Yes ,4N <br />COMPLETION El Stove Pipe XChristie Box <br />Screening Method: <br />Verified Chain Custody: El Yes LINo <br />SPOILS <br />Contamination Noted: 1%Yes ENo <br />If yes, spoils storage Location: Ot. <br />Covered: ryi Yes LIN0 <br />If yes, material: c2,1 )vg-ixtv, 5 <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 1- <br />Grout Material: t\le-ak C2tm2,444 <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest 4Bags Thickest Thinnest gBags <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 />MATERIALS/DEVELOPMENT <br />Casing Type: r 0110iftle* <br />Blank '-27,7 Feet Screen 3 Feet <br />Slot Size: <br />Bags of Cement: A ( <br />Bags Sand/Gravel: 11 <br />Type/Brand of Bentonite: V11.1-4 e>t <br />ire <br />kl_S <br />Filter Pack Type/Size: 14 ) cit.1. <br />Type of Method: 'cr-A.AAA,Li_L4 J4LM.L'4( <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 />-W ft <br />slotted <br />sacton <br />51> tt. <br />Gallons of Grout Used: 4t) -jotli Ain", <br />XVVell Installation Eli Well Destruction <br />0Boring Installation 0 Boring Destruction <br />METHOD USED <br />0Pressure Grout 00ver Drill <br />0 Gravity IgliTremie DOther: <br />pti <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com