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*NITORING WELL INSTALLATION REPO. <br /> Date: S / �P� /S// CONSTRUCTION --�/ <br /> Premise Addres :��6 5. ��ij�o�fL Total Depth <br /> Screen Length (from) r/ci (to) 74 <br /> Well No.: � l n� Filter Pack (from) S/S (to) 75 <br /> Bentonite (from) (to) S'S <br /> Inspector: Grout (from) _ (to) <br /> Drilling rig type i2 M - li•`a t✓ <br /> Permit No. Auger O.D. I.D. 3 f <br /> Consultant <br /> Completion - Stove pipe/christie box (circle one) <br /> \ I <br /> Geologist J n� t/ sftk'op <br /> T <br /> SPECIAL PERMIT INFO. ABOVE-GROUND <br /> CHRISTY4= <br /> COMPLETbN COMPLETION <br /> Distance to sewer line G=ndSurtaca <br /> Domestic well on site - (y <br /> If yes, location and distance - 9tout <br /> ft. <br /> n. _ <br /> _= <br /> SAMPLING <br /> r - <br /> Holding Temperature z6 P 2C 0 Zi, = 8 <br /> Method sx�on <br /> Screening Method l = yrawlpadc <br /> Tracking Sheet - (y ) _ <br /> SPOILS <br /> Storage Method MATERIALS/DEVELOPMENT <br /> Contamination Notes - + n )/ <br /> Storage Location d A 9 s` / �'C Casing type �� 2 <br /> d� �� 20 �p Blank SD ft. Screen 25 ft. <br /> �/ Slot size <br /> Bags cement <br /> GROUTING Buckets bentonite / <br /> Bags sand/gravel <br /> Depth to water Filter Pack type/slze 10A,5Ai 3 <br /> Mix Ratios ZO / Surge Block: - a/ n ) <br /> Installation Method -F/Liv+M16 Discussed with geologis : - <br /> Quantity Installed Sa4l doe &AIr Type of method a <br />