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4,.n11ITORING WELL INSTALLATION REPOIt <br /> Date: A6✓ m �!„��� 0200 7 CONSTRUCTION <br /> / IIS'--a Boa' <br /> Premise Address: X39 .5, C�-�itf+�' a-Sf ee: Total Depth lI S 4gej- So 1 -I•;II fd w <br /> Screen Length (from) A0.57) o) /da ' <br /> Well No.: M W - 18D 2 Filter Pack (from) /D g (to) 98 ' <br /> Bentonite (from) (to) 4L <br /> Inspector: Vi e-k Mc el rfn f:::!l Grout (from) 91, ' -(to) 5u,-4s0t <br /> Drilling rig type Se>t 1 e- Ea Id _ <br /> Permit No. Auger O.D. 6-;n6jrc I.D. G.5' 'inelier <br /> Completion - Stove pipe irisde o (circle one) <br /> Drilling Company: .5 6dde J7ri)l i n g� <br /> Driller: dr'� 1 reeee casing <br /> �ss]stgnfs Je"�F” N.s wander,Jason 1-ernq zalcz height <br /> Consultant_ 13 S L �_c <br /> VTA <br /> Geologist Ti 4 -a n n 11; C,,3 .DIA ABOVE-GRCIJNO <br /> CONFLETCN 743OX <br /> COMPLETION <br /> SPECIAL PERMIT INFO. T"3 P n Ground Surface + _...�.� <br /> Distance to sewer line_ h» ka n i,1 n 10�t7'IS'20 0P�m pram <br /> Domestic well on site - (y/(E)) 3o' a•BP�,K -T r1'G ft. <br /> If yes, location and distance - 37 34�3��3'l' ft- <br /> 38' Flo' 40"r, —L=f2. <br /> 42,S. <br /> s t� 48' so oPP"° : _ a <br /> 5211941 _ m <br /> SAMPLING o? G'D»? OJ��aSQtjZ fIeS ' �s; G'SPp■. alot•.o.i M' c <br /> Holding Temperature '4'° (� 44 _ q.sb", soc7cn = �" off <br /> �� r = P� <br /> YBI <br /> Method_ ice �n co n I�er � �' — <br /> Screening Method -P 14) 70' - /,e. <br /> Tracking Sheet Ey n ) 7.2' = g-8 ep— <br /> ft. -" t2- <br /> SPOILS ?8' - � <br /> 8,2' - 22, opwL <br /> " mo.. <br /> Storage Method S5 -� ��rrx clru rn( 8�'_ c 98 MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( / ) gg� _ rrr� <br /> Storage Location 0Y1 s 90'-0,3�Casing type .2 -i n 0, S .li. A4Ie- 40 <br /> 0.Sew,-,Blank /00 ft. Screen S ft. <br /> 94' -0,7�+�' �»,Slot size__ 0.010 ;"A <br /> GROUTING 98, �''7 :Bags cement aG b <br /> P"Buckets bentonite 3/4 ,b 60-I A&I F -3 "pemo) <br /> Depth to water_ 4R 46U+ iO3 - o Bags sand/gravel a 5,6-111 L4e i s Lu tre <br /> Mix Ratios °� wafe, 4, in 4,'7-I b b4q r Filter Pack type/size_ A-3 <br /> Installation Method r C Surge Block: - (y/n <br /> Quantity Installed a b J - >2_,it. � '�•�'P <br /> S �0� " Vscussed with geolt: - (D/ n ) <br /> _''f-pP'"1' a of method <br /> 9Xff-11 ca( w erwas c4n+4j 1081.-0,3p <br /> EH 29 29 <br /> C?r►cG,vF - USGoC3,Uell , <br />