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4 <br /> L T 0 N G E 0-S C I E[,4 C.E RP R: `2 10 LF, pA o 0 u.. P0 <br /> MONITORING KELL INSThLLATIO24 REPORT t. <br /> Date., f gqa CONST&qCTjQN <br /> A,+-', I? sr, <br /> Premise Address: X7-6,v Wall No. /)/1 3 <br /> Inspector-. ^'ckc-&- f Total Depth <br /> Screen Length <br /> Filter Pack. ;63- <br /> Permit No. Bentonite Pellets <br /> Consultant A-.Zrov Se-v"c:e-%c-e-- Grout-- 5 <br /> Geologiat /"A-r 7-H CW Completion-stove pipe <br /> Auger O.D. (j <br /> Auger I.D., <br /> SAMPLI)qa <br /> Holding Temperature <br /> Method-- <br /> Screaning Method <br /> Tracking Sheet (y/n) 0OABOVE-OROUND CHRISTY-BOX <br /> WLETION COMPLE71ON <br /> OWwnd SWUM* <br /> SPOILS I <br /> storage mathod 57-oe-kP,'1,,4 <br /> Contamination Voted yao/no <br /> Storage Location 6L <br /> V <br /> Wood <br /> Distance to sewer line a6c0on <br /> Domestic well on site yes/no W"park <br /> if yes, location & distance <br /> —79rc. 7P <br /> qa2uzlR(-; <br /> M=JUALS 11SRD t <br /> Depth to water ::_66_- Casing type 'Y- 4-0 <br /> Mix R&tio9j' 5-ACC /" tX Blank.!f- ft:—Screen—eft. <br /> Inatallation Method -re-f—:4z- slot size O. o 1 0 i <br /> Quantity Installed —I 5`..ZA Bags cement------- <br /> Buckets bentonite <br /> Bags sand/gravel 2 <br /> Filter paejt type/site ion 7a,%o', <br />