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MONITORING WELL INSTALLATION REPORT <br /> 9-/ .yfl Sri 5 <br /> Date= <br /> CONSTRUCTION ,, 11 C71'PI� <br /> Prem' <br /> a reae: Well No. MW <br /> Prem. <br /> lSI7 w <br /> InstTotal�- Total Depth__ <br /> �rXflN(3�'l -IY� � <br /> Screen Length-!-9L0-5--P- <br /> /&. <br /> Filter Pack__ - Z6, /¢ '~- <br /> c./� Bentonite Pellets - St. -�i %Q. <br /> Permit No._y/J � Z�jar Grout <br /> ConsultantCompletion-Stove pipe/ hristie box <br /> Geologist .Ab� <br /> Auger O.D. / <br /> SAMPLING Auger I.D._ <br /> Holding Temperatre �--- s— <br /> Method <br /> __o <br /> atlrxup <br /> Screening Q�� --�� <br /> Tracking Sheet [vim) \ <br /> v MbOVE-GNWND <br /> GOWLEDON CHRISTY.WX <br /> SPOILSCOMKETION <br /> trourd Sulaca <br /> Storage Method <br /> Contamination Noted - yes �n• <br /> Storage Location <br /> 0 <br /> SPECIAL PERMIT INFO almuC <br /> aacian — S <br /> / — ffad pads <br /> Distance to sewer line 4i5b <br /> Domestic well on site - yes/(d-o,-) <br /> If yes, location 6 distance - —_a. - �n <br /> GROUTING MATERIALS USED: <br /> Depth to water_ Casing t}pe_ <br /> Mix Ratios <br /> Blank. �G. ft. Screen147 ft. <br /> Installation Method ��f *"64 i4*" Slot size_ <br /> Quantity Installed Bags cement <br /> Buckets bentonite / <br /> Bags sand/gravel <br /> Filter Pack type/size - <br />