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MONITORINGWE.LL INSTALLATION REPORT',. ; <br /> Date �BiP 1` ?lir �,� 2d0�1' CONSTRUCTION �... <br /> Premise Address:_ 1 �D -lid n n of SLe&C.64- Total Depth e -�2 --- - <br /> Screen Length (from) 4;7 fr1Ct(to) t Lk <br /> Well Na.: 111 1.11 " 1 )72'!,J -Z Filter Pack (froii) �7-I�0I (to) <br /> # Bentonite (from) (to) -.e, <br /> Grout (from) (to)_S 0 r d ate. <br /> Inspector. L'. � � Q !� - <br /> -�. . ' Drilling rig type <br /> Permit No. <br /> Q Auger O.D. I.D. <br /> i Completion - Stove pig cltristie box {circle ane) <br /> Drilling Company: <br /> Driller: F7 rag :Rig �-' caswRg <br /> ri-SID e4i3art Q 8err�Nrdo ux»+4rt � hez-cht \` <br /> Consultant CoAd <br /> r <br /> 4-r. T no toi i esu xhc,. <br /> It <br /> Geologist, QVABOSvE-GRcUND <br /> • � CO i43�'tET IC3 N Gk�:STY-a0 X <br /> C4 PLEM H <br /> SPECIAL PERMIT INFO.; - Cx x�rziVStsiscY <br /> grcyvt <br /> Distance to sewer line a 5�n .s�' - <br /> Domestic well on site - ( y/( !'} ' it. <br /> if yes, location and distance - 3o ft. <br /> a977 '-F MIM-3 _ 2 :r <br /> yr — <br /> SAMPLING ; f ilorai ► ' <br /> 49- c n <br /> Holding Temperature <br /> Method - s <br /> o•L s4 �_ <br /> Screening r .S <br /> Method +hA- <br /> Tracking Sheet n ) 4y� O V H�,.LtJ4� <br /> - rnco-3- 3D'-3S' -zx.8ppm- <br /> SPOILS - 35'"qb 41,I�Aps " <br /> roSt were, W t3 <br /> Storage Method S S ' u MATERIALS EVELOPMENT <br /> I , <br /> Contamination Noted - n) <br /> Storage Location R"yl S __ Casing type S C�1 d B 40 C- <br /> Bunk :12- 7 fr, Screen h. <br /> Slot size D• 2 0-, YLA <br /> Bags cement 1 A tit <br /> GROUTING K <br /> Buckets bentonite 1 5 4/ r. <br /> Depth to water; X33 7_ �1�d� - Bags sand/gravel ao s <br /> Mian Ratios i q4,110. t.� S'44f� Filter Pack type/size Z <br /> "Surge Block: - <br /> �stallation Method " � � n} <br /> Quantirylnstalled � Discussed with geologist: - n) r � <br /> j NPS X-44 C�h� :of rnctliod <br /> EH 29 29 W z R <br /> . `� �� cid/ate'`�t� 5..�`�-of� rL�'.�—,r�/�`'�'�'-l='rho 10 .-�ya�d.��rh•, <br /> S. <br />