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'MMMWAFEPEW- <br /> -INITORING WELL INSTALLATION 1, .ORT <br /> Date: ' 3--- <br /> CONSTRUCTION <br /> sk <br /> 630 ' • e-6 -It/� A 57- " Total Depth go -Qe e-r ' <br /> Premise Address: - 411 <br /> -` � <br /> Screen Length (from)' ?,- 9—(t0)— <br /> Well No.: - Filtet Pack (from) (to) � <br /> M.-eMr�r"--"---^ <br /> Bentonite' (from) 1 '3 <br /> Inspector.�' ` l�ll LA 1Y1 Grout (from) ® _ (to)- 13 <br /> Drilling rig type t <br /> Pezmit No. S U- 2 _ Auger O.D. 8- r Ach I.D. <br /> Completion- Stove pipe/cbristie box (circle one) <br /> Drilling Comping. �« <br /> C. h rl 1 .tom�a� <br /> Driller: �' height <br /> consultant caging/'� "1`'�`+ �—�sl�f T <br /> Geologist3 i« (flaj& •- <br /> ABOVE-GROUND Ci WISTY-80X <br /> ccwLET10N COMPLETION <br /> SPECIAL PERAUT INFO. Ground Sulacv <br /> Distance to sever lice grout <br /> If yes, location and distance- ft- { <br /> --ee <br /> SAMPLING tod <br /> &*=on <br /> Holding Temperature C- <br /> . gr__ <br /> Method C-0 n l -r w l I C i s•� _ <br /> Screening Method 01: 1) _ <br /> Tracking Sheet - n) <br /> Jt. f7 ft. <br /> SPOILS <br /> Storage Methc d be,r re-(-5, M, TMRIALS/DEVELOPMENT <br /> Contamination Noted -�i''' n) <br /> Storage Location t1A bvA rteA o V',s jC_ Casing type <br /> Blank 2.0 R Screen-, 2 tit. <br /> Slot size d <br /> GROUTING Bags cement <br /> Buckets bentonite 2 o <br /> Depth to water 2-9 . 2- 5 — Bags sand/gravel r11v <br /> Mix Ratios_ -- Filter Pack typeJsize <br /> Installation M!thod-� Surge_Elock:_(.y_ n <br /> QuantiryInstalled Discussed with geologist: - / n) <br /> Type of method <br /> EH 29 29 <br />