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P A- OF—__L_ <br /> MONITORING i7ELL INSTALLATION rZ_x'.PORT /4 I I Y y;�1 l /�bvn.�Po n rn�►�" <br /> .YY lfompQn y _ <br /> .g Environmen-ha Geeteohn;�: <br /> �rillinGi - Y;q C',M� - 75 <br /> �J •J � r;) I#-, rs , R0V1and Mic� vQ1Cej& <br /> Date: IZ- 14 CONSTRUCTION �ILJ!i11 Jas rzloc <br /> aviclk IJ Ste1- fn 17 Yllzrf `'/ cf /mUJ- 1 <br /> Premise Address: .20.57 S. EI Dvrao�o Sf-, Well No. E Vv -Z b � or10owe,)-- <br /> Inspector: y G}( i /VLC Ar+•+g� Total Depth $Q --Fee-+ <br /> _ 1 "��s <br /> Screen Length_ a0 J elf ` <br /> :'ilter Pac �222f �_ Sb' -}0 2 8 bSJo <br /> Bentonite Pellets Erl V i rs )LJ 3fee4-(28'-.2S'bs9� <br /> Per it No OO S 844 9 Grout ), S eef bS,3 <br /> Consultant QJvgn _,fid Geo n J i fora rn e,1,}-aj Tn 'l Completion-Stove pipe/christ'_e bC:t <br /> Geologist B i l l 1- C'J f)w- - A GE (R <br /> LJiS Ora rale,a Auger O.D. <br /> lir4 SofGti�� r� <br /> Auger I.D._ 7in61,eu dnd( G.2 ,nb(1�� rcalr.�1 � <br /> SA-MPLING )0-i„G)L <br /> tt V Qltl�8 rJ <br /> holding Temperatur IJ D b!G (NA �s cx u OO <br /> Method <br /> Screening MethodN/} <br /> Tracking Sheet kB0VE-GCUN[) <br /> cNalsox <br /> COMPRON <br /> CCMPL ETION I <br /> S?OILS Cnxnd Surface <br /> 9 r:ct <br /> Storage Method Fi-15S-.Aa) <br /> ) on Ll rUm s <br /> Contamination Noted - •.•es no 2 h• <br /> Storage LocationnnSi}e � \ 8 (t• <br /> SPECIAL, PERlMIT INFO. — m <br /> I <br /> C <br /> 'D� r slotted — <br /> Distance to sewer line <br /> ta�-Son — <br /> Dcmestic well on site - yes/®c <br /> If ves location & distance = P--<k <br /> = i <br /> GROUTING <br /> M1?TERIALS USED: <br />)ept;, to water. Z'7 �2,�- bSS� e-4o <br /> r f' Casing type 4-ine.�-, � ,l-, <br /> eJvI <br />!i:< Ratios__ I 9'f Il b�Q fJ - ire. L7L4l/Doi oT Blank 3_ ft. Screen 20 <br />.nstallation Method A ej _y hcJ4 ` 4Le r Slot Size—,o 030 <br />:ua^tits Installed _ �9 QS/30 Allor�s Sacs cement_ $i X 4 -�,b aG�,tQ/. �e-re,r0¢..7�3t <br /> U 3u5' s benton' te /,,�-bg Cn✓ fu 1dq <br /> r� 55 -5ra rums Bags sand/gravel-L+--/O -/b C X LgP�'s Lustre- <br /> ri_ter Pack type/sire -A3 _ <br /> tal Billed Time Per Site .2, 5 boyrs <br /> Ta Perlrit Finalized <br />