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0 a <br /> MONITORING WELL- SOil, BORING <br /> INSTALI.ATION REPORT <br /> Date. I 7//, IQ<' CONSTRUCTION <br /> Premise Address: Monitoring Well # <br /> Site Code:— Total Depth — <br /> Screen Length (from) (to) <br /> Permit Number(s):— Filter Pack (from) —(to) <br /> e Bentonite (from) —(to)� <br /> Inspector: G <br /> Grout (from) F (to) <br /> ter 2 -� <br /> Drilling Company: Depth to Wa33 ;IQt ' Auger O.D. <br /> Driller: Casing Typc Slot size <br /> Filter Pack Type/Size <br /> Consulting Firm: ' " " Completion - Stove pi /Christle box <br /> Geologist: ✓i.cX p Surge Block: -_(y/ n) <br /> Samoline r/ CONSTRUCTION <br /> Method of Storage: XA <br /> Screening Method: Monitoring Well # O <br /> Total Depth <br /> S xi )lis Screen Length (from) (to <br /> Sµ�ra�e ►�.�elhod rind Lo tion: wT Filter Pack (from) (to)I� <br /> llldd�$ n t 6fi � Bentonite (from) �F (1c a <br /> Grout (from) <br /> Depth to Water <br /> lin C Auger O.D.Mix Ratios: Casing Type—pe/Size <br /> � Slot SI _ <br /> n1 <br /> installation Mcihod:—: Filter Pack <br /> Completion - Stove pipe tris <br /> Quantity: tie b <br /> Surge Block: - (y / n) <br /> CONSTRUCUON <br /> CONSTRUCTION <br /> Soil Boring # Total PCPth Monitoring Well # <br /> Depth to Water Total Depth <br /> Me <br /> Ihod 6 Destruct on ae Screen Length (from) ((o) <br /> per— Filter Pack (from) (to) <br /> Soil Boring # J Total De th Z� Bentonite (from) (to) <br /> Depth to Water 3 <br /> 3d P Grout (from) (to) <br /> Z - ate— Depth to Water <br /> et d tf c traction _ t) Agger O.D. <br /> Casing Type Slot Sizc <br /> Filter Pack Type/Size <br /> Soil Boring # G Tupc <br /> Tot Pth-- Completion - Stove pipe /Christie box <br /> DePlh to Water I Surge Block: - (y/ n) <br /> Method of Dcs uction <br /> Soil Boring # nPI01 I Depth <br /> Depth to Wat"L <br /> Method of Destruction 00 <br /> x <br /> -7(,Jq� <br />