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COMPLETION El Stove Pipe <br />casing <br />height <br />111Christie Box <br />SANAAQUIN <br />COUNTY <br />Greatness grows here. <br />EnvironmentiiHealth Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: 0/11 / IV Inspector: L-D-1 CONSTRUCTION <br />Facility Address: -7 05" Orkka— <br />Well Address: Total Depth: <br />WP# Du 3 .Ke Well#: Drilling Rig Type: <br />Soil Boring#: f i <br />Drilling Company: <br />6Z— Min 2" Annular EHD Seal Verified: <br />6."4-4fr jse- <br />Driller Onsite: Screen Length rveuk — <br />Geologist: l'1 /4-4-A4-- S'%)."0•%-t- <br />Public Water System Onsite: 0 Yes ENo <br />Domestic Well Onsite: LI Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br />Verified Chain of Custody: 0 Yes 0No <br />SPOILS <br />Contamination Noted: 0 Yes DNo <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: 0 <br />Grout Material: A-64"-- <br />Gallons of Grout Used : t 5 <br />111Well Installation 111Well Destruction <br />0Boring Installation IP<-3oring Destruction <br />METHOD USED <br />0Pressure Grout DOver Drill <br />P'<avity ETremie ElOther: <br />Water <br />gallons <br />Cement 47Ib <br />Bags <br />Water <br />gallons <br />Cement 94 lb <br />Bags <br />Thickest Thinnest 4 Bags Thickest Thinnest # 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 />El Yes 0No <br />From: To: <br />From: To: <br />From: To: <br />From: To: <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 />BentonitelGement 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 />Consultant: Filter Pack <br />Bentonite <br />Grout <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T. 209 468-3420 I F 209 464-0138 I www.sioehd.com