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r <br /> NOM TOEING WELL INSTALLATION REPORT <br /> CONSTRUCTION <br /> Premise Addre s: �• !/� well No. A414) -4- 213 <br /> Inspector• Total Depth Z ° <br /> Screen Lengthii <br /> Filter Pack <br /> Bentonite Pellets <br /> Permit I FG- 3 3 3 S� Orout I.1 <br /> ConsultantCompletion-Stove pipe/ hristie x <br /> Geologist <br /> Auger 0.D. <br /> Auger I.D.L,' <br /> Bolding Temperatures a <br /> Method ,&Jdd&. t,I.�..to -T I <br /> Screening Method P <br /> A60 243ROUND <br /> Tracking Sheet (y n) COMPLETION CHR95TETK1N <br /> SPOILS ���Qislsd 8Y:la" <br /> O<mA <br /> Storage Method <br /> Contamination Noted - yes no �. <br /> Storage Location t,, & <br /> BPNCIAL PERMIT INFO : <br /> Distance to newer line Gu �L dmtid <br /> "orlon 'x = <br /> Domestic well on site - ye /n = <br /> If yes, location & distance - — Ovid Po* <br /> aRa�rrnEs <br /> NATERIALSUSED: <br /> Depth to water—h2! Casing type 2 PSC/ <br /> Mix Ration / Blank _ ft. Screenft. <br /> Installation Method u(yrn ,t�� Slot size_ . A/h <br /> Quantity Installed J Bags cement <br /> Buckets bentonite <br /> Bags sand/gravel_, <br /> Filter Pack type/size Z-//-7- <br />