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s,+NITORING WELL INSTALLATION REPOl,,.w' <br /> Date: e42 r ua r„ 13 -020,0A JCONSTRUCTION <br /> Premise Address: w: Total Depth SOve�-,(��e �i//�� <br /> Screen Length (from) 35-- (to) 2a <br /> Well No.: M Filter Pack (from) 3S (to) <br /> Bentonite (from) G (to)� <br /> Inspector. �✓i e-k, M.&earfn� Grout (from) (to) <br /> Drilling rig type <br /> Permit No. 40 so2.s75' Auger O.D. I.D. '2-V <br /> Completion - Stove pipe/ tstie box ircle one) <br /> Drilling Company:�1_��f;�ll_n� <br /> Driller: jess e �' casing <br /> A -ss,:rf4rnf: mat-co Romirar <br /> Consultant c.C.0 a IV <br /> Geologist w; Il -- <br /> AIZVE-GRCUND <br /> COMPLETION -80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface + �.� <br /> Distance to sever line - ofoo`l <br /> Domestic well on site - (yn .T <br /> If yes, location and distanc ft- <br /> tt. -�— =r .k <br /> i. p <br /> is i <br /> C <br /> SAMPLING •lot'.ad <br /> aocycn - — <br /> Holding Temperature Ala <br /> gravel pack <br /> Method_ sfa,r e�E, so I i n Ca�l� <br /> Screening Method '--h fiD ' P ID -w°Gf O pso rhe _ <br /> Tracking Sheet y n ) — <br /> a.. ft. _ s, ft. <br /> SPOILS <br /> Storage Method__ $c - M_ ATERIALS/DEVELOPMENT <br /> Contamination Noted - (y n <br /> Storage Location 6;Z-0 W. ObAr Casing type An <br /> Blank ao ft. Screen_ ft. <br /> Slot size Z iRlGS li <br /> GROUTING Bags cement (�o,r <br /> Buckets bentonite <br /> Depth to water -2s Bags sand/gravel - djAii <br /> Mix Ratios 9 !�- ,2 S 5 sj//nls �� Filter Pack type/size <br /> Installation Method r 44 - Surge Block: - (y/ <br /> Quantity Installed 40,6 ft& Discussed with geologist: - n) <br /> Type of method <br /> EH 29 29 <br />