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"MONITORING WELL INSTALLATION REPORT <br /> Dal r s u-n n't) , Aba,t-* 'F' <br /> Date: A U 4 U + I L3 a a CONSTRUCTION <br /> Premise Address: li 3 9 ti &+r Bef Total Depth_ 75--Aee,f- k, r q <br /> Screen Length (from) 7� (to) As- <br /> Filter No.: V1/ `.28 Filter Pack (from) 7 (to)� <br /> I Bentonite (from) G 'f (to) 6 2- <br /> Inspector: En g:�, Grout (from) !v 2- (to) S v r�Gf <br /> — Drilling rig type CA1 15 175- <br /> Permit No. 5 i� Q� Q� q.Z Auger O.D. <br /> n Completion - Stove pipe christie box ircle one) <br /> Drilling Company:_A// Well Aba h on M eR� <br /> Driller:_ jua rn and M , q / li casing <br /> A -I nn ff-- .��. � height <br /> Consultant Ap✓dTt!!P (��� (;/J l/9 rnq 21,0,4 <br /> Geologist L..U) S Ga rdea ,_ T <br /> ASOYE-GROUND j <br /> CflMF'LETbN IOFMPLET�!ION <br /> SPECIAL PERMIT INFO. // Ground Surface <br /> Distance to sewer line Qt�Dji-Yd-�� grout <br /> Domestic well on site - (y/0) <br /> If yes, location and distance - 2 ft. <br /> N A ft. <br /> Coll, p�tcO(so� l saxPl<s a..t:�l0 4�SSD = 0 S Go'G�' '701 7S- lbs — <br /> SAMPLING <br /> ttom" _ <br /> aec5on _ <br /> Holding TempQrature_ (% — <br /> Method I G e '111 vivW pack <br /> Screening Method D <br /> �y r' _ <br /> Tracking Sheet F� n ) <br /> �s ft. "' _ ft. <br /> SPOILS <br /> Storage Method S5- MATERIALS/DEVELOPMENT <br /> Contamination Noted - <br /> Storage Location B rl S fie- Casing type_ .2-I n c,1— Sc l-,eyLtJ e, �}0 <br /> Blank (p S ft. Screen / b ft. <br /> Slot size pip ;,L�,ltEj <br /> GROUPING Bags cement_ <br /> 1 Bucketdbentonite C'e+ % " is <br /> Depth to water ^' ,2 f so <br /> Bags sand/gravel <br /> Mix Ratios .2 5 / S(9� bv..a,Filter Pack type/size 3 <br /> Installation Metho r�„t; Surge Block: - (Q/ n ) <br /> Quantity Installed a b J Discussed with geologist: n ) <br /> EH 29 29 G f D U GcIQS rn � i n Q S3 Q,4/lam Type of method 5 y-r g e. b1 o cue <br /> drum . C/ <br /> G r o ut U tea( w 4 s <br /> al.*-fie. or f la nom( -t� p e IL <br />