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MONTTORING VML INSTALLATION REPORT <br /> CONSTPU.C[ZON <br /> Date: <br /> �r Total Depth (to)�� <br /> Premise Address: w Screen Length (from) <br /> ;Filter Pack (from) (to) <br /> Well No.: :Bentonite (koro) Eto) <br /> Grout (from) (tO) <br /> Inspector. Drilling rig tYPe <br /> Auger O.D. I•D. <br /> Permit No. Completion - Stove pipe/cluistie bO� (csrcle one) <br /> Drilling Company: a <br /> casing <br /> Driller� FM-] <br /> : eicht <br /> Consultant <br /> Geologist1°AYE-G�CUtaQ cp:mx ' <br /> cx rx1 Sul." <br /> SPSCIAI pGRMIT 1NF0. <br /> Distance to sewer lineI . <br /> Domestic Yrell on site (yft- <br /> lf yes, location and distance <br /> 1 .vim M <br /> O <br /> • C <br /> p <br /> SLMPLJNG sQccn <br /> Holding-Temperature <br /> Method <br /> Screening Method = : <br /> Tracking Sheet - (Y <br /> SPOILS <br /> MATERIALS cVE .OPMEN1 - <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing typ e <br /> f <br /> Storage Location clank fc Screen <br /> Slot size <br /> Bags cement <br /> GRpLMNG Puckets bentonite <br /> Rags sand/gravel <br /> Depth to tivater Filter Pack type/size <br /> Mik Ratios Surge Block: - (y/n ). <br /> ,jr1stallation Method Discussed with geologist: - (Y/ n} <br /> Quantity lrutalled Type of Method <br /> EH 29 29• _ . <br />