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CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: LI Yes 0No <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br /> <br />To: <br />To: <br />To: <br />To: <br /> <br />slotted <br />socdon <br />COMPLETION El Stove Pipe EIChristie Box <br />casing <br />height <br />ABOVE-GROUND <br />COMPLETION <br /> <br />CFOR1S7Y-BOX <br />COMPLETION <br />Ground Surfacs <br />grout <br /> tt <br />gravs4 pads <br /> ft. ft. <br />SANdOAQUIN <br />v-11.1mw —COUNTY--- <br />\,,45:0",/ Greatness grows here <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 3\ 112-k Inspector: <br />Facility Address: 2:30(0 a)C,14--La Sir)C1000, <br />Well Address: <br />WP# Li 7t0 Well#: <br />Soil Boring#: ."6 <br />Drilling Company: 0e5t-a)(19-0XplorafiCiA JAC , <br />Driller Onsite: <br />Consultant: C4L G),1 DAL, <br />Geologist: AAE2 e,1 ‘.:1/1/Ab& I rt • <br />Public Water System Onsite: 0 Yes n No <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: fu Yes 0No <br />SPOILS <br />Contamination Noted: 0 Yes 111No <br />If yes, spoils storage Location: <br />Covered: 0 Yes 0No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: t\lc> <br />Grout Material: t•4_0..)c NjottrA <br />Gallons of Grout Used: 2-5 <br />VZ <br />0Well Installation Li Well Destruction <br />0Boring Installation KBoring Destruction <br />METHOD USED <br />0Pressure Grout 00ver Drill <br />KI,Gravity 0Tremie 00ther: <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />A.N Bags of Cement: <br />\9cAl d•Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest II Bags Thickest Thinnest # Bags <br />2.5 5 1 s 10 1 <br />s 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 s <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 />10/16/2017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com