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MONITORING WELL INSTALLATION REPORT <br /> adv " 0 ° <br /> Date: 1.4 . 20 1 0 CONSTRUCTION <br /> Premise Address: :302 El "lora d[6 %S Y+ce Total Depth (o S <br /> 1 Screen Length (from) G 57 (to) G O <br /> Well No.: M%A/ - /0 Insi-4flea( dd ct��U ` Filter Pack (from) G S (to) V <br /> MuJ- $ - o -s;fie, i n �h s I d euv411( o+z Lafa ett Sf Bentonite (from) S-8 (to) S!;— <br /> Inspector: <br /> S <br /> Inspector: _ V 1 C'E lu CCS r�nr r., 4e r: Grout (from) S� (to) <br /> .17Q.y13 /}v f'p <br /> Drilling rig type Land ra_ L LfF k <br /> Permit No. S k * 06 L 11 8 S Auger O.D. 1$ ' `n <br /> Completion - Stove pipe/ hristie box c o <br /> Drilling Company: Ad l W2!l A bQ n rho n rn e,— <br /> Driller: p�,�0�y'�" �S IdG►f casing <br /> OL <br /> GtIJ.Si G L height <br /> Consultant AGIc/anccs� rP�, y,ror�rn�,� _TnC. <br /> (A � <br /> Geologist C&7t Q.[_ oY7-s,tL - ban;e l V� f fan ue va- <br /> ABOVE-G ROUND <br /> COMPLETION Ct�A1STY 80X <br /> COMPLETION <br /> SPECIAL PERMIT INFO. Ground Sumacs <br /> Distance to sewer line , 40 4-Pe-+ grout <br /> Domestic well on site - (y n) 4 S-s-- ft. <br /> If yes, location and distance ft. <br /> �a ft, <br /> = m <br /> SAMPLING G�JD �Sd i f e10114ee.'01 o <br /> totted is <br /> Holding Temperature <br /> Method V"'W Pack <br /> Screening Method —_ <br /> Tracking Sheet - (y/ n ) — <br /> SPOILS <br /> �'hGdr;Jf P�'J Gills i� Joe- <br /> Storage Method JrS Y '- .d_ MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ <br /> Storage Location 3DB F. I Casing type 'V <br /> i1,—, dr; ll.r rs rnq.,('. �rry,'ja- i n q r2r-34 <br /> 34//•� Blank GO ft. Screen <br /> afrvY,�• Slot size O, 4 2..0 ` <br /> GROUTING Bags cement / <br /> Buckets bentonite 1 boll44 rD CtT D +bi <br /> Depth to water G - Bags sand/gravel_ 3 /0 <br /> Mix Ratios 7i.q llnv✓ Filter Pack type/s' e -d�3 Lapi S <br /> Installation Method Ve&la-lii--Surge Block: - n) <br /> Quantity Installed Discussed with geologist: - /n ) <br /> EH 29 29 Type of method <br /> -Th-e- U dr?�,�c �m t t -7k d r 1t v� ►� b o ,17 rcJ, rn x <br /> .tTfh �� . G1SD �I11-d 64X44, <br /> hada, �-k <br /> ra-4, p.el ss JlLb13 <br />