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�IITORING WELL INSTALLATION REPOR-9 <br /> 7 37- 2_ <br /> 7- Z ��. /0 <br /> 7( _0 LI 00 <br /> Date: -fr 2 / 5 3/9//� CONSTRUCTION <br /> Premise Address: �GGLO lam— Total Depth 6 23r I1r <br /> Screen Length (from) Z-1 iO (to) 9 <br /> Well No.: � #2 3 Filter Pack (from) Zy (to) 7 <br /> Bentonite (from) -J (to) 5i <br /> Inspector: ta Grout (from) 5 (to) C) <br /> 9Q q Drilling rig type F 5 A <br /> Permit No. G/ /� Auger O.D. 1(c <br /> Completion - Stove pip Christie box (circle one) <br /> -onsultant <br /> ieologist stIck-up <br /> 74- J VT I% <br /> SPECIAL PERMIT INFO. A8OVE•GR 0 <br /> COMPLETION CHAISTY-BOX <br /> Distance to sewer line /✓ COMPLETION <br /> Ground Stu}acr <br /> Domestic well on site - (y(D <br /> f yes, location and distance - <br /> pp 1s tt. <br /> _1_ft. tt. <br /> SAMPLING <br /> 0 = ° <br /> Holding Temperature Un sloes = g` <br /> Method Ov`( �.o¢ •+� �` sx�on <br /> Screening Method &oU gave,Pack <br /> Tracking Sheet - n) <br /> SPOILS � <br /> Storage Method s MATERIALS/DEVELOPMENT t W-Ak . <br /> Contamination Notes - (y/ ) <br /> Storage Location iMU Casing type 2 G rjc� �� <br /> Blank---'I-ft. Screen_ l5 ft. <br /> Slot size .02.0 <br /> Bags cement <br /> GROUTING UtA Buckets bentonite r _ <br /> 1 k III Bags sand/gravel <br /> Depth to water ILk Z Filter Pack type/size LS4;3 <br /> Mix Ratios 0 1 $°(•v Surge Block: - (y/ n ) <br /> Installation MethodDiscussed with geologist: n ) <br /> Quantity Installed tua th Type of method l�Aru.• _ <br />