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- - - L OF 3 <br /> MONITORING WELL INSTALLATION REPORT Vi Pf , 1( ay,� <br /> Gre 9 ) il ; <br /> y� e AJeff <br /> n, ( ✓�ssirfa ��` . /17 fin SAO <br /> Date : Noyewber I `]. .2� d08 CONSTRUCTION r, DO <br /> S <br /> Premise Address : 317 S , E ) 1) 6rQ C.�o %Sl, Well No . _ �� r®'a\` �/ • <br /> Inspector : Vick Me Calx Total <br /> Depth o Ch <br /> Screen Length 30 � <br /> Filter Pact: row,/ ' �7/� <br /> Bentonite Pellets g rG t �`�" "`-) <br /> Permit No . S12A. JJ • Grout G ( - � - �[ Oy�. ud ¢� <br /> Consultant Pt/J VA nfl P/� �rEa h�/r rd V1 nl,,enTC!/t Completion-Stove pi e / christie box / U.- � w <br /> Geologist� YliP � i�V� -' � ��t �.2 J <br /> Auger O . D . <br /> Auger I . D . <br /> SAMPLING <br /> 77o3diag Temcerature IJ IE 3,$ -S O -- - <br /> Method *AJA ys- I/0 0 <br /> as U <br /> Scraeaing Method_pL,-b 13, S- <br /> 23 -Y <br /> 23 -5 2b 4.1 •- <br /> A5- -3d12 AacvE-GRCUND cs ai <br /> Tracking Sheet �/ n ) 1,2� CCNU I. CN COMPLETION <br /> J Grourxl Surlxe <br /> SPOILS kyu rddW(,, 20Mi � U <br /> J Gran <br /> Storage Method 5�5- m// fl <br /> Contamination Noted - yes / no ft <br /> Storage Location OW .Si fe. ) O <br /> SPECIAL PERMIT INFO . — c - <br /> cloned =_ � <br /> Distance to sewer line UYlkm ol4 y` tacdon <br /> Domestic well on site - yes no gmye, pack <br /> = <br /> I : ves , location & distance _ <br /> r) h. - 3V _ tt. <br /> GROUTING <br /> pMATERIALS USED : <br /> Depth to water (5bi )d4d &O Casing type <br /> Miz Ratios ) 4441(rn.r a!FLc1Q}o-r `la o�, b[}pS [r 31ank� ft . Screen �D <br /> Installation Method__ n%lyslot size Oro <br /> _ . . .. _ty _Tr. stalled 6Ak lam- U W+k. g♦'ru ,� Baas cement °�, � J f'u p'f�2x/_,( <br /> Buckets bentonite ) if C�' r/ olid , <br /> Bags sand / gravel /O6 .4= Z41;L7;7 ' V1J} <br /> • _ '_ ter Pack type / size aoff i vh t- <br /> ' � tal Billed Time Per Site <br /> late. ? ermit Finalized <br />