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v MONITORING WELL INSTALLATION REPORT <br /> Date:_ CONSTRUCTION <br /> Premise Address:_ 30Sd/ 64eoxq 5.7- Total Depth <br /> Well No.: /95 y Screen Length (from)' S�3 (to) <br /> Filter Pack (from) <br /> Inspector: J. Ydn r"ry Bentonite' (from) 3c9 (to)-5� _ <br /> Grbut (from) C9 (to) YCR _ <br /> Drilling rig type Rova.ey <br /> Permit No. Auger O.D. 8 I.D. <br /> Drilling Company: AV9 Completion-Stove pipe/christie box (circle one) <br /> Driller: m4A,4'C' casing <br /> height <br /> Consultant AG,t <br /> Geologist / ocr- yiA4* <efu4 <br /> ABOVE-GFIOUND <br /> COMPLETION 4SiY <br /> SPECIAL PERMIT INFO. OMPtEnoN <br /> C3rwnd Surixv <br /> Distance to sewer line grout <br /> Domestic well on site - (y � . <br /> If yes, location and distanc <br /> 413 <br /> tt rt. <br /> o <br /> SAMPLING sbttad = c <br /> Holding Temperature sac�en <br /> Method = vivs,pack <br /> Screening Method <br /> Tracking Sheet - (y/ ) <br /> y8 — 56 ' <br /> h. <br /> SPOILS <br /> 4 <br /> Storage Method MATERIALS/1)MLOPMENT <br /> Contamination Noted- <br /> Storage Location Casing type .2 � Pl.` <br /> Blank-----q 3 ft. Screen fr. <br /> Slot size 0,010 <br /> GROUTING Bags cement_=594) <br /> Depth to water Buckets bentonite i <br /> Mix Ratios y Bags sand/gravel 9y,•asl <br /> Filter Pack typesize -7t3 <br /> Installation Method _Surge._Biock:__(_y_/3W <br /> Quantity Installed Discussed with geologist: - (y/io <br /> EH 29 29 Type of method_?( <br />