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LIOC��-^iCz WF.:�r (�iS TAL'-�i►CN �.oCFZT }'�*� <br /> C„✓��. , q- ���lJ CONSi�UCTTON <br /> Date: o�� <br /> se Address: �� Tocal Depart <br /> ?-e== Scee_Z i e.^.gc�: (fro¢t) (co) <br /> • F1te•:?ack (frota) 7 (to) <br /> Well No.: Bentonite (&oat) (to) ' 3 <br /> Grout Cfrom) (to) b <br /> [nspec:oc: Drming ns type 8461 <br /> �,� � Agger <br /> ?e_^•.ic No. Comaledoa- Scove pipe/chesde box (circle one) <br /> Drilling Company: U ' <br /> Cas-,.ng <br /> he;ghn <br /> yA �2�: <br /> Coasul'�a.*tc <br /> Gaotogist VI/L ABCVC-SCIL CHSZ-I Y-cv^ - <br /> SPCriaf ?E3-NUI- IN=O. <br /> grout <br /> Disz=ce to sewer line \ 5(] <br /> Donesdc well on site - C Y AJA =am <br /> It yes, location and distance - _ <br /> I <br /> tad <br /> is �" • <br /> Koldirg <br /> cure ..vera <br /> Met-hod e G b= <br /> Sc.ee^.ing lrie_�tod Y-&Vb✓a— =_ <br /> Traccng Sheet y n) �.7d��:L V <br /> 70 <br /> SPOILS , ..� _7-:5 SLu�f' <br /> I <br /> to/ 565 MA i E�UALSMEVELOPNSN-r <br /> Storage 'Method <br /> Noted - n) 2- <br /> Contamination Pll <br /> Casing 7/Fe <br /> I Scorage Locadon lJk -je Blame fe Steen ZO [G <br /> Slot size - �- <br /> CROU iNG Bags ceme-Zc t <br /> Buckets bencoctite <br /> I ! Bags s=d/vavel $ <br /> Depa` t d water Filter?ack typesize 3 <br /> tiILC dttCs Surge Block'. - C y/ a <br /> Inscalladon Method <br /> Quand:y Installed Disc, sled Wirth geo ogis� - n) <br /> Type of=ethod _ <br />