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N 25 <br /> MONITORING WELL INSTALLATION REPORT y' T�A <br /> S <br /> I� <br /> � � � CONSTR.UC'iION <br /> Date: ia/ p <br /> l S <br /> Total Depth <br /> Premise Address: 3 N 3 c"'/ /� Green Length (from) <br /> 6/,o `Y 3: �,� .���J Filter Pack (from) <br /> Well No . // ' Bentonite (from) <br /> Grout (from) (to)— t�L— <br /> Inspector: <br /> 2 L Drffiing rig type ecru'.z <br /> Auge*O.D. I.D. <br /> permitNo. o/' ��n Completion- Stove pipE� x Ocie one) <br /> Dulling Company. <br /> casia4 <br /> he_ght <br /> consultant <br /> (�Nr� " ,v�• AYE-GROUND <br /> v C✓"hrp:�ci ION C--+Ap-=ICN <br /> �_ Gc�ss�d Str`aes , — <br /> SPECIAL PERF T INFO. pmts <br /> ^� <br /> Dis-,,ante to sewer line VL <br /> Domestic well on site - C Y/V fL <br /> If yes, location and distance , _ = J <br /> ed c <br /> S=C 3K:C11 - <br /> Holding Temperature =� <br /> Method <br /> Screening Me - <br /> Tracking <br /> et - C y/ n) ♦ ; - ts. <br /> SPOILS <br /> TS AI,S/DEVELOPMEN`T <br /> Storage Method <br /> Contammarion Noted - C y/ n) Case Ving type /o ft. <br /> / � <br /> Storage Location Blank /S f` $Green <br /> Slot size - <br /> Bags cement <br /> GROUTING Buckets bentonite <br /> Bags sand/gravel <br /> Depth to water c� -1�- Filter Pack typesize <br /> Mix Ratios <br /> -Surge Block: - CV n ) <br /> Installation Method �^�^^ " Discussed with geologist - C Y/ n ) <br /> Quantity Installed Type of method h <br /> EH 29 29 <br />