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M TORING WELL iNS 1f _aTION REPORT <br /> Data: C J� � CON=L. UCTfON <br /> P-e .ise Address: 2f D3 L j � Total Deprh 29 <br /> Irk��hn Steen Length (from) 77 (to) <br /> Well No.: — S Filter Pack (from) 2-7 (to) ! <br /> Bentonite (from) /z. (to) 10 <br /> Insoec'or. Grout (from) /D (to) o <br /> DrMing nig type BS` <br /> Pe.^ic No. Auger O.D. 7-t- I.D. 3 z <br /> I� Completion - Stove pipe/chrisde box (circle one) <br /> Dr1li-:g Company: 1t V/��6' <br /> .// casing <br /> Diller: SEL 114's L 7I�T height <br /> Consultant <br /> Geologist A3CV:vaCUNOc- <br /> SPECL-'k-T 'DERN97 <br /> GroundStstaINFO. <br /> i <br /> cut <br /> Distance to sewer line 9tr t <br /> ft. <br /> Dor..esdc well on site - ( y/ n) t z <br /> if yes, location and distance - J�R <br /> — c <br /> stoned — e <br /> SAMPLING soon — <br /> Holding Temperature <br /> Method k� <br /> Sc eening MecZod _ <br /> Ttactiag Sheet - y n ) <br /> SPO(LS <br /> ScapTeMeamd QRf r[ (/�° °max • MAi=FUAI.S/DEVcLOPMEN7 <br /> ati Noted - ( y/ n) Z Pie, �� / 0 <br /> S cation Casing type '-T�-� <br /> Blank ffi I fr Screen 15 ft <br /> Slot size 102- <br /> Bags <br /> 02Bags cement <br /> ,/ Buckets bentonite L <br /> Depot to water Z f Bags sand/gravel <br /> Mix Rados QIA Filter Pact type/size <br /> lns:allat on Method Surge Block: - (y/Da <br /> Quartivi Installed q Discussed -with geologist n ) <br /> Type of method <br />