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Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: III Yes EINo <br />To: <br />To: <br />To: <br />To: <br />COMPLETION CI Stove Pipe <br />casing <br />height <br />EChristie Box <br />CHRIST'-SOX <br />COMPLETION <br />Ground Surface <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />SAN.AAQUIN <br />COUNTY <br />Greatness grows herr . <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: Inspector: "44/lia\Stfiti CONSTRUCTION <br />Facility dd ess: jiçc <br />Well Address: it <br />WP# 14/100 41 er Well#: <br />Soil Boring#: <br />Drilling Company: V W <br />Driller Onsite: V4 <br />Consultant: <br />Geologist: r(2/1700- <br /> (-1914-5 <br />Public Water System Onsite: 111 Yes <br />Domestic Well Onsite: <br /> <br />111 Yes <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: ID Yes ON° <br />SPOILS <br />Contamination Noted: CI Yes EINo <br />If yes, spoils storage Location: <br />Covered: ElVes ON° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth:6 1 .-- < <br />Depth to Water: 1 1 <br />Grout Material: AjOrr <br />Gallons of Grout Used: <br />ElWell Installation OWell Destruction <br />El Boring Installation l*oring Destruction <br />METHOD USED <br />111Pressure Grout DOver Drill <br />Gravity tremie ElOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest nags Thickest Thinnest flags <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 40 4 <br />12.5 485) 7. 25 50 5 <br />15 30 30 60 6 <br />17.5 35 7 35 70 7 <br />20 40 8 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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com