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CONSTRUCTION <br />COMPLETION CI Stove Pipe 111Christie Box <br />casing <br />height <br />ABOVE-GROUND <br />COMPLETION CHPUSTY-BOX <br />COMPLETION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: E Yes LINo <br />To: <br />To: <br />To: <br />To: <br />Ground Surface <br />t <br />slottad <br />mocton <br />gravel pack <br /> ft. ft. <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />SAN-JOAQUIN <br />—COUNTY <br />1:1 ; Greotness grows here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: _3 2-1 Inspector: <br />Facility Ad ress: 27306 ICLAP_ 5fo&kj7ii <br />Well Address: <br />WP41 4.17A0 Wen: <br />Soil Boring#: 6 3 <br />Drilling Company: kOe."-D-\--e(Vbk Q,,,K00( <br />Driller Onsite: <br />Consultant: Cie C0,1 , <br />Geologist: PthAe,e,( 'Sirveyf , <br />Public Water System Onsite: 111 Yes <br /> <br />ON° <br />Domestic Well Onsite: LI Yes 111No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: <br /> 0 Yes ON° <br />SPOILS <br />Contamination Noted: 0 Yes El N o <br />If yes, spoils storage Location: <br />Yes ON° <br />Grout Material: 2, <br />I GROUTING or DESTRUCTION Total Depth: <br />Gallons of Grout Used: 1`5 <br />Depth to Water: (071 TV,r <br />0A- <br />Casing Type: <br />MATERIALS/DEVELOPMENT <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 />Covered: <br />If yes, material: <br />El Well Installation 111Well Dest uction <br />III Boring Installation CI Boring Destruction <br />METHOD USED <br />111Pressure Grout ClOver Drill <br />1=1 Gravity ETremie 1110ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94Ib <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest 4 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 />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