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CONSTRUCTION <br />Total Depth: <br />Drilling Rig Typ : /41104 S46-"--- <br />Min 2" Annular EHD Seal Verified: <br />II° <br />LO <br />II 1r <br />El Stove Pipe <br />casing <br />height <br />climsTy-pcx <br />compuEncN <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />COMPLETION <br />El Yes 11No <br />To: <br />To: <br />To: <br />To: <br />Chi7:11-3ox <br />SAN:JOAQUIN <br />COUNTY— <br />Greatness grows here. <br />Environmer 'Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date:' Z. 7 Inspector: 4 fr-t-ik. <br />Facility ddres : -Z,..( 521 S, 61 <br />Well Address: Galn,...J.e <br />WP# Well#:41.41,0 • <br />Soil Boring#: <br />Drilling Company: (Hi- S 1,-,,erY__ t qp ko'-df' <br />Driller Onsite: ril (Vj'.,-jJc <br />Consultant: <br />Geologist: <br />Public Water System Onsite: Yes ON° <br />Domestic Well Onsite: El Yes <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />IViethod: <br />Screening Method: <br />Verified Chain of Custody: I=1 Yes LIN° <br />SPOILS <br />Contamination Noted: El Yes ZrNo <br />If yes, spoils storage Location: <br />Covered: CI Yes ElNo <br />If yes, material: <br />GROUTING or DESTRUCTION Total/Depth: <br />Depth to Water: <br />Grout Material: Material: <br />Gallons of Grout Used: 51) • <br />OWell Installation El Well Destruction <br />El Boring Installation El Boring Destruction <br />METHOD USED <br />ElPressure Grout 1110ver Drill <br />LI Gravity r<rnie E0ther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 941b <br />Bags <br />Thickest Thinnest It Bags Thickest Thinnest # Bags <br />2.5 5 1 s lo 1 <br />5 10 2 10 20 2 <br />7.5 15 s 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 />MATERIALS/DEVELOPMENT <br />Casing Type: C.44 (•• <br />Blank ZAD Feet Screen -Z t7 Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: 2._ A <br />Type/Brand of Bentonite:Mai <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 />62.11-r-ao <br />10/16/2017 <br />1868 E. Hazelton Avenue r Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I, www.sicehd.com