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CONSTRUCTION <br /> <br />Total Depth...g, <br />Drilling Rig Type: <br />Mm 2" 2" Annular EHD Seal Verified: <br />From '. 3° <br />From:2,7 • *1 <br />From:lic 3 <br />From: ; 3. <br />0 Stove Pipe <br />To: , <br />TO:SP -t< <br />To:2,1 ; Lf <br />To: <br />lk6T-istie Box <br />caelng <br />height <br />c4iFiSTY-80X <br />COMPLETION <br />SANJOAQUIN <br />COUNTY— <br />Greatness grows here <br />Monitoring Well/Soil Boring Inspection Report <br />Date: V Inspector: <br />Facility Address: 24,67 E.9tAwrvl CANN4n <br />Well Address: <br />WP# cpc,3 -7 (dlo <br />Soil Boring#: <br />Drilling Company: AA ve-lA <br />Driller Onsite: <br />Consultant: Artg-S" <br />Geologist: <br />Public Water System Onsite: 0 Yes 0No <br />We I I #: a.d - <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />COMPLETION <br />ONo <br />Environmer Health Department <br />Domestic Well Onsite: 111 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: Yes 0No <br />SPOILS <br />Contamination Noted: El Yes 0No <br />If yes, spoils storage Location: <br />Covered: 0 Yes El N o <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: <br />Gallons of Grout Used: <br />0Well Installation El Well Destruction <br />El Boring Installation 111Boring Destruction <br />METHOD USED <br />OPressure Grout 0Over Drill <br />0 Gravity OTremie 00ther: <br />MATERIALS/DEVELOPMENT <br />Casing Type: PUL fL <br />Blank 20., Feet Screen -1,43 Feet <br />Slot Size: . ow <br />Bags of Cement:.— 9.4 L-6 Lj <br />Bags Sand/Gravel: %,% 2— <br />Type/Brand of Bentonite: <br />Filter Pack Pack Type/Size: <br />Type of Method: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest 4Bags <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 />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 />10/16/2 017 <br />1868 E. Hazelton Avenue Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com