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yNITORING WELL INSTALLATION REPOI� <br /> Date: Febrctary CONSTRUCTION 804� � <br /> lti <br /> Premise Address: SSlI VV i G�i_Qr'fGr �.1/ei Total Depth 7 / 4? -7 7 t f� <br /> Screen Length (from) '7? (to) ? <br /> Well No. M W - 7q Filter Pack (from) 777 (to) 7 0 <br /> Bentonite (from) Yi 7 y (to) 67 <br /> Inspector: _ a4lg r 'et . Grout (from) d 7 (to) <br /> Drilling rig type :1 h+n Sam 7,L <br /> Permit No. D $'oZf-74o eas, Ae9cre--D: G-i`nr.L_ I.D. <br /> Completion - Stove pipe/ tstte bo (circle one) <br /> Drilling Company: VV-D C- <br /> Driller: ga k6a.5'ln., casing <br /> �`tSSisfQryfs; <Qt"iCin IlZorb,�ck /'� T height <br /> e�Consultant0-0—cs+e r�-s 2 e 201-)sa. <br /> Geologist_ ABOVE-GROUND <br /> COMPLEflON 1X!TY-800-NUX--' <br /> --- <br /> SPECIAL PERMIT INFO. Ground Sumacs <br /> Distance to sewer line groul <br /> Domestic well on site - (y/ L 7 tto <br /> If yes, location and distance - ft- <br /> ?ZR, <br /> *: C <br /> SAMPLING `• <br /> sIoC.a.9 <br /> cn <br /> Holding Temperature - Y1 ►" �q}Gy ��`�, <br /> Method ma 19 Pack <br /> Screening Method P i ..D <br /> Tracking Sheet - n <br /> s Y aaf,'`c�F�o�t'as-- �'L.t•t. � tt. <br /> SPOILSi-gr��` <br /> Storage Method S - ry rj,,S OwJ,ft-4 MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n G 20 6h*,4� <br /> Storage Location_ 0 /1 S 7 t e -44-1, "v4-j,.Grey Casing type 4�-i h-dL 2a adv/c 40 <br /> Blank 172 ft. Screen S ft. <br /> l�mi 6� �,�-�,, Slot size <br /> TI02 <br /> GROUNG a ti 12.5- oV+ilfS Bags cement S gY- lb b 4449 <br /> *5U GeIY' Cr-Te.p Buckets bentonite bnt E&JI Pur26oW 3/6"mijt.coWe <br /> b gn* n I+r_(y''1. Bas sand/gravel 1 Do-1 o h e <br /> Depth to water_ a Q g gr <br /> Mix Ratios4- 9'!•-1 b b z-I Filter Pack type/size ' / 1 z <br /> Installation Method— o S' Surge Block: - (y/� <br /> Quantity Installed 1'b h Discussed with geologist: - (y/0 <br /> a4 A,, -4-7 +fut ¢;ar t Type of method <br /> EH 29 29 <br />