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Mr_"TORING WELL INSTAL.I.ATION REPORT <br /> Date: 2-11-2"2 <br /> _ CONSTRUCRON <br /> Premise Address: /_ IU�Y 1x Total Depth <br /> r Screen Length (from) Z5 (to) 12 <br /> Well No.: .3 Filter Pack (from) 25 (to) 9` <br /> Bentonite (from) 8 (to) 5.5 <br /> Inspector: Grout (from) S-S (to)_) <br /> 2 Drilling rig type gL <br /> if <br /> Pernit No. �L Auger O D. O Z-` ID. (o µ <br /> /'/ A.'Y, <br /> C Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: !/� <br /> ` casing <br /> Dr11er. £ height <br /> Consultant <br /> �s-cm G� �, ♦ r7171 ♦ i <br /> 7 <br /> Geologist AE&c-4RCUND ' <br /> CONPI=i C^ <br /> ZN tSY-3CX <br /> Ground Suixs <br /> SPECIAL PEP-NUT INFO. <br /> grout <br /> Distance to sewer line S•S <br /> Domestic well on site - (y! n) fL <br /> ��it. <br /> If yes, location and distance - �' <br /> . <br /> "�. <br /> _ c <br /> $106d _ c <br /> SAMPLING ascion <br /> Holding Temperature dot '4ic-.2. Z; _ gmvw"-ack <br /> Method CA ,4,s4-7f X voo­� <br /> Screening Method / _ <br /> Tracking Sheet - n ) M <br /> SPOILS <br /> Storage Method OX t le5 MATERIALS/DEVELOPMENT <br /> Contamination Noted - y n) 3 �rt�� <br /> Storage Location Bit Sr�.1�" Casing type -f 4a <br /> Blank To fr- Screen l ft- <br /> Slot size .OZ. <br /> GROUTING Bags cement 15 _ <br /> Buckets bentonite .24.. <br /> Depth to water Bags sand(gravel 8- <br /> 01 t <br /> Mix Rados ! 9 t D Filter Pack type/size 3 Ca"A <br /> Installation Method Surge Block: - n) <br /> Quantity Installed 'Z*iA 2a. ' Discussed with geologist: - y n <br /> cofType of method CA- )-Q r � <br />