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,hoNITORING WELL INSTALLATION REPO <br /> CONSTRUCTION <br /> Date: <br /> - i Total Depth 2 <br /> Premise Address: (2S© L P k' Screen Length (from) ' s (to) d <br /> Filter Pack (from), 25 —(to) S <br /> Well No: # , rY" �, _(to).� (a I. <br /> Bentonite +(from)_$_ <br /> c Grout (from) <br /> Inspector. .., <br /> Drilling rig type <br /> Cf 2 ` OSIS _ Auger,O.D.�_O.2 � LD <br /> Permit.No. • � �•. - <br /> _ Y T Completion=Stove pipe �boxcircle one) <br /> Drilling,Company: S? C,k <br /> Driller: casing <br /> "a_` height <br /> Consultant y, <br /> Geologist <br /> _.e ABOVE-GROUND GHFi1S"iY48oX <br /> ICOMPt.1=Tf0N COMPLETION <br /> SPECIAL`PERMIT INFO. - Ground Swfwa <br /> `-Distance to sewer line- grout- <br /> Domestic well on site (y/.n) -ft. <br /> If yes, location and distance - i ' M <br /> SAMPLINGon <br /> le <br /> Q . a _Holding Temperature gpd <br /> Method` <br /> Screening Method - iol <br /> Tracking Sheet GY n ) <br /> SPOILS <br /> 'z' <br /> StorageMethod �2u1rt.S'° '° MATERIALS EVEI.OPMENT <br /> Contamination Noted,- _n) - 10 r5� T 4 <br /> Storage Location oiS SiTI�' ' Casing typ40 plc- ' ` •` <br /> r x Blank lo ' ft. Screen <br /> j • ' . r4 a Slot size <br /> GROUPING Bags cement 3 r3R+CzS : i <br /> I ` f r Buckets bentonite UA3 r <br /> Depth to water I-7 1 Bags sand/gravel lsa V— <br /> Mix Ratio <br /> Filter Pack" a size 3' <br /> Ratios" `�` n.$ (fit.. -.- . . - � typ / <br /> Installation Method Surge Block: <br /> QuantityInstall ed €'.3 t l i� �� Discussed with geologist: - n'),". <br /> Type of mediod <br /> EH 29 29. d <br />