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u.,,dNITORING WELL INSTALLATION REPOIN..j <br /> Date: CONSTRUCTION � <br /> Premise Address:-// lf/ Total Depth <br /> Screen Length (from) .53 (to) <br /> Well No,:--- ,, 7 - S Q Filter Pack (from) S3 (to) <br /> Bentonite (from) 7 (to) <br /> Inspector: Vi Grout (from) lyS' (to) <br /> Permit No. O .S yr f�f�e <br /> 9 Drilling rig type <br /> _ /) S-6 1 9 Auger-O.D. r I.D. <br /> Completion - Stove pip istte ox circle one) <br /> Drilling Company: w D e, ek 10 212 &— Cox. W&kr <br /> Driller: ma k"4 rI' caging <br /> � <br /> S.'(S+4G '� , J; m.n tJ, J figj 't4'7"�1 J414 2-4r <br /> Tr77 height <br /> Consultant G�,gs-iac��- n1/I�r�rS -f 6�SSri.(CA6{ ) 'V <br /> Geologist LA u ►^C�'n l7 0�d`�-i n e 1, <br /> rfl <br /> ABOVE-GRC(JND <br /> COMPLETION1SVN <br /> SPECIAL PERMIT INFO. Ground Su lwo �...� <br /> Distance to sewer line_ iwk.Yl aZ,hne flf0"t <br /> Domestic well on site - (y A3)) S ft. <br /> If yes, location and distance - A , /� tt- <br /> fJ "1 ft. <br /> •:r:Ala P <br /> SAMPLING - QV D 5a leJ LTJeYe�60Ille-'Ijel�, <br /> ." — <br /> l��al secycn <br /> Holding Temperature N A <br /> Method 5' �i s�/A <br /> - gravel pack <br /> Screening Method /0; <br /> Tracking Sheet - (y/ n) — <br /> s-/t y�3—ft. — <br /> it- <br /> /g'- <br /> SPOILS a 3/8 cp•#Gv <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Noted - 'V <br /> Storage Location_ O-n mss,-fY, Casing type c2 - ; ,,.�,_ p 1Jc"i <br /> Blank 48 ft. Screen S ft. <br /> Slot size Q, 02 0 <br /> GROUTING Bags cement y h T <br /> Buckets bentonite 3/ 'I Xk <br /> f <br /> Depth to water Bags sand/gravel d I <br /> Mix Ratios ,2Q po�flFilter Pack type/size <br /> Installation Method' r T � Surge Block: - (y n <br /> Quantity Installed '7bgd2 � - So-„�v;ti..�( Discussed with geologist: - (y <br /> ,baktk 6„4a n Type of method <br /> EH 29 29 C&Y&04 v' 4V ti S 92A <br />