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�ANITORING WELL INSTALLATION REP <br /> Date: 2 q2 CONSTRUCTION <br /> Premise Address: SL: Lr7DP Total Depth r <br /> 25 <br /> Screen Length (from) 5 (to)^_r�D <br /> WeII No.• _,- �"� (cam Filter Pack (from) 2_5_____-- _(to) S <br /> Bentonite (from) 8 ' (to) G f <br /> Inspector: .,_.S • �l l7 _ Grout (from) 19 ' (to) <br /> Drilling rig type <br /> Permit No. Q 2 — (r2— Auger O.D. 10. I.D. <br /> Completion - Stove pig uistie box Icircle one) <br /> Drilling Company-J2T <br /> Driller• 1Psl.L casing <br /> height <br /> Consultant C .P <br /> Geologist �lsl�+r' 1'l LL'I? 2A <br /> ABOVE-GRCVND CFRWY-BOX <br /> COMPLE CN COMP=ON <br /> SPECIAL PERMIT INFO. Ground Sw1we <br /> > f <br /> grout <br /> Distance to sewer Tine <br /> Domestic well on site - (y/ n j ; it. <br /> If yes, location and distance - lt- <br /> ft. <br /> h. a <br /> !f M <br /> R <br /> SAMPLING Blot• d c <br /> sedcn <br /> Holding Temperature aG _ ,�� <br /> gra Panic <br /> Method I C."s -a '— <br /> Screening Method t =_ <br /> Tracking Sheet n ) '•:' _ <br /> SPOILS <br /> Storage Method_ MATEWALS/DEVEI.OPMENT <br /> Contamination Noted - (y/ n) L1 Storage Locationw n jl 5t'riS Casing type 2 Ck� 40 �_ <br /> Blank 10ft. Screen_ Sift. <br /> Slot size .6>2 <br /> GROUTING Bags cement <br /> f Buckets bentonite UW <br /> Depth to water Bags sand/gravel I hbA le- <br /> Mix <br /> LMix Ratios 9_ Filter Pack type/size_ 41 `5 <br /> Installation Method Surge Block: - (y/N <br /> Quantity Installed Discussed with geologist: - V/ n) <br /> Type of method L`f 11P'11 <br /> EH 29 29 <br />