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NIONTI'MUNG wl?1.1. - St)1l. BORING <br /> INSIAi,1AIION RETORT <br /> 3 <br /> Dnic: / CON '.3RUC I-Q-K �h f <br /> Premise Address: <br /> $ r 41�lnnitaring Well # 'rill <br /> Site Code: Tuts! Depth <br /> Screen Length (from) (to <br /> Permit <br /> Number(s):—Filter Pack (from) 2 (to) <br /> l3cntonite (from) (to) <br /> Inspector: U� Grout (from) a s {to <br /> Depth to Water <br /> Drilling Company: U � Auger O.D. 2� d <br /> 1)rillcr. Casing Typc-- . t Sizc <br /> Filter Pack Type/Size <br /> Consulting Finn: Completion - Stove pipe Christie box <br /> C=cologist: Surge Block: n) <br /> Sam lin CONST UC O <br /> Method of Sinrage: Monitoring Well # <br /> Screening Mcthnal:— �— Total Depth <br /> Screen Length (from) {to <br /> Sp9ils C S '� Filter Pack (from) (ta) <br /> S ewag e et nd and I-c cat( : Bentonite (from) (to <br /> Grout {from) {to} <br /> Depth to Water <br /> Auger O.D. Slot $ize <br /> C,rcyutin Casing Type <br /> Mix Ratios: Filter Pack rype/Sire <br /> AJ Installation Method: Completion - Stove pipe 1 Christie box <br /> Quantity: Surge Block: - (y / n) <br /> CONSTRUC—TION � CONSTRUCTION <br /> Soil Bnring #-- - --Tod l l�epil' Monitnring well # <br /> `�} <br /> Depth to Water- Total Depth <br /> << �v lethod of Destruction Screen Length (from) (to) <br /> Filter Pack (from) (tn) <br /> \� Bcnionite (from) (to) <br /> _--,r-,—,Soil Boring # Total rDepth�� Grout (from) (to) <br /> vDepth to Water fp — Depth to Water <br /> AMcthodclrE)"truction �\ugcr O.U. <br /> Casing Type Slot Size <br /> Filter Pack IT pc/Sizc <br /> Soil Boring #Total!Depth--� Completion - Stove pipe ! Christie box <br /> Depth to Water 1 U Surge Block: - (y 1 n) <br /> Method of Destruction, <br /> Soil Boring # Fota1 Depth <br /> Dcpth to Water <br /> Method of Destruction <br />