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CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: eYes CI o <br />Screen Length From: tt 12 To: <br />Filter Pack From: log TO: I 2.." rj( k,reer <br />Bentonite From: .4.5, To: t,05( <br />Grout From: t.. 'j To: <br />MATERIALS/DEVELOPMENT <br />Casing Type: Sc. k. LIP <br />Blank Lis, Feet <br /> <br />Screen Feet <br /> <br />Slot Size: .1:7 10 I-51 .1 <br />Bags of Cement: 'Si L jitrytt- uw-Imrwr-y4rr prfaef4i 2111110/1' <br />Bags Sand/Gravel: 1 3 <br />Type/Brand of Bentonite: C.,0A.A- t1/4,,,„4„ Or Ike TT <br />Filter Pack Type/Size: %42- <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 />COMPLETION El Stove Pipe <br />casing <br />height <br />ie Box <br />CHFILSTY-BOX <br />COMPLETION <br />SAN JOAQUIN <br />COUNTY <br />Greatness grows here <br />Environme I Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: \\.1,4. 1 Inspector: 1--0'1" iYA-TvA• <br />Facility Address: -2-L5-14 f 12)..w4e2.. 51— <br />Well Address: t* -16ru <br />WP# Well#: (.As) <br />Soil Boring#: <br />Drilling Company: 6.44/1-0 ,Ctv•Nre, r-ittls)rA-4-`"7 <br />DrillerOnsite: C_IApev <br />Consultant: <br />Geologist: CAA4l4vii <br />Public Water System Onsite: 111 Yes IIINo <br />Domestic Well Onsite: LI Yes El No <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: El Yes 111No <br />If yes, spoils storage Location: <br />Covered: 0 Yes EN° <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: <br />Grout Material: <br />Gallons of Grout Used: <br />1=IWell Installation 0 Well Destruction <br />El Boring Installation ElBoring Destruction <br />METHOD USED <br />E Pressure Grout lilOver Drill <br />E Gravity EK-emie 1110ther: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />Cement 941b <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 />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com