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-,4WNITORING WELL INSTALLATION REPOI,r <br /> r.'/;// 'VOA ob .z r/f os - T1ia- ,b6Yehdie-4.-.-- mw Y-27 w�s��az, <br /> c <br /> 07-S rQlr- 1 n;�hf• <br /> Date: rr-A4 124 1l �2�ar F". I2�2-008 CONSTRUCTION <br /> ab I <br /> Premise Address: Std rr�SO�oY�i Total Depth �'r( ¢L?2.�' <br /> 4'Jq«,.r h Oe/f4 ftj- �'Screen Length (from) 17? (to) 17 2- <br /> Well No.: M w /S — 17 Filter Pack (from) T7 (to) 69 <br /> Bentonite (from) 4� L 9 (to) G 7 <br /> Inspector ek; L,ar 7ee4 . Grout (from) G (to) <br /> Drilling rig type Li `�- <br /> Permit No. ©D 5 .2-3-100 Auger O.D. - ` <br /> Completion - Stove pip iristie box�cle one) <br /> Drilling Company:_ G r A etl,I r; If aka <br /> Driller:_ OeSSe- P4+I s casing <br /> JJi ftQ.cy'� NVare-6 V)n re z'_ '� ' he_ght <br /> Consultant_ fe ttA — �ovFirf .t A-ss0' (OtZ9 V <br /> Geologist wi i r G�Qn Sk lq� J -� <br /> ABO VE-GA CUND <br /> COMPLETION X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Gourd Surface <br /> Distance to sever line IJ n v1 OW <br /> Domestic well on site - (y AD T 4.�l ft, <br /> If yes, location and distance - ft. <br /> �ft. <br /> `J"r4 ;c F/�lza ' <br /> SAMPLING / i"o <br /> IIOC.o.•i w: C <br /> „i <br /> socticn <br /> Holding Temperature NSI <br /> Method /42;'-Vl, ;s "> vel paac <br /> Screening Method P .D --Pr rkr,, I o' - 6 = all <br /> Tracking Sheet y n ) :. <br /> 17 ft. '� = ft. <br /> SPOILS <br /> Storage Method S - strr�,e,� MATERIALS�DEVELOPMENT <br /> Contamination Noted - (fl n ) Gz0 w,Ck4ff �• <br /> Storage Location w/ D W. d"r-1,611 INa,� Casing type a" ndJ2_ Jell 401VI6 4-0 <br /> GrovzBGt,✓a�/ter t-c�ci s rnpan�.. � w Blank ?Z ft. Screen <br /> Slot size_ G.0 20 <br /> GROUTING 0 Bags cement 1�¢� <br /> Buckets bentonite/--504:' P4J v <br /> Depth to water 0 Bas and/gravel 'mr �s <br /> Mix Ratios S+ �A f- .90 / J d-�L - ce ter Pack type/size � <br /> Installation Method 05.0-01 -7-ra'i. e � —(7$,I) ;Surge Block: - (yffzist <br /> Quantity Installed Discussed with ge : - CY) n) <br /> T <br /> -,ype of method <br /> EH 29 29 <br /> �1�1 Jul nL� ��`" E1e�t�'", � `� D�► � <br /> ��y 11 moi' ,.s . <br /> S r <br />