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*NITORING WELL INSTALLATION REPO <br /> Day -sun n� f abou f 77'r <br /> 0 <br /> Date: U n 0- nRSi eZ0 17- CONSTRUCTION <br /> Premise Address: /� D 0 DY,47 l rr. !-FYrv) JV_ Total Depth ;f <br /> Screen Length (from) .25".0 (to) 20, d <br /> Well No.: AS - 3 Filter Pack (from) .75.0 (to) /9_J- <br /> Bentonite Bentonite (from) /9.S (to) /6.S <br /> Inspector: V ;CJ(. }ne-4�n } <br /> r- y� Grout (from) /6.S- (to) Sum <br /> Drilling rig type C 171 E 7S- <br /> Permit <br /> SPermit No. nS�{ n t)/' t;- 14 j} Auger O.D. F-1AIL <br /> Completion - Stove pi a/christie (circle one) <br /> Drilling Company: 1/V D �. li 4 <br /> Driller. - J� // casing <br /> height <br /> Consultant d T SnC <br /> Geologist lRa, l 41' 14 n��rA') _ <br /> ABOVE-GROUND <br /> COMPLETION IS'TY-BOX <br /> C PLETION <br /> SPECIAL PERMIT INFO. J Ground Surface <br /> Distance to nyertineL i c - Un k�1000rt proof <br /> Domestic well on site - y ) <br /> If yes, location and distance - I <br /> /.20Pn l' eft. 9.stt. <br /> S 3 0 <br /> SAMPLING /U 2 7S 1'P'm ebrted = c <br /> �Sr -11 d rge v,, sac5on = .2 <br /> Holding Temperature :144e (1 .20) 5 <br /> Method 1 d-4-9 12 ['(1z/0- v 1'80401- -' _ gavel pads <br /> Screening Method �S r 7.vjgpr , <br /> Tracking Sheet - y n ) — <br /> ZSft <br /> . tt. <br /> SPOILS <br /> Storage Method drd r MATERIALS/DEVELOPMENT <br /> Contamination Noted -CYY n ) <br /> Storage Location l�.fc�_ Casing type a SC�rP��le 40 <br /> Blank a`t 0 ft. Screen <br /> Slot size 2 0" <br /> GROUTING a Bags cement '-I,S 9V& yr IIAr�r/-5-1 <br /> p1Q.3kBuckets bentonite Ibuej SZ Cg-.-, /y iiLW), <br /> Depth to water '✓�� r b,pt•;', (' f�at�a Bags sand/gravel /00itla0�s Cl mGx Lao�r2 <br /> Mix Ratios j 3 S Ia;Llm0 Filter Pack type/size 211 Z <br /> Installation Method / Chid Surge Block: - ( y/0 <br /> Quantity Installed /- / f Discussed with geologist: - C/ n ) <br /> �$(; Type of method <br /> EH 29 29 <br />