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PA-.A 1 OF 1 <br /> MONITORING WELL INSTALLATION REPORT I gn <br /> Drt ili <br /> `D - ver �0�9 y Qbov� 45°� �i �56�t/tn� Jorri`� Zi?��rn ie>ra� <br /> rig - Powar Probe 9630 <br /> Dr; 1lw CesArSnzurrza <br /> A$;iJfan�5'JV4n Cervantes A► egraz <br /> Date: Deaembe 9 2008 CONSTRUCTION V;,:+or Mgca <br /> Premise Address: 42S LQrGjt'Rd. *rk6y Well No. MW - Z2 <br /> Inspector: Virk• o-&rtnrTotal De?th ' 20 <br /> `J Screen Length 4rtrr>`;ty- 5- C / 'Sareen) <br /> Filter Pack -rre1N 20' - 4 ' IisA <br /> Bentonitz Pellets m - Sg <br /> Permit No. QO SS"'7I D Grout 2 -Ore -1-b Sur 6.G2 <br /> Consultant 5+r•4ttt5 EnYironrne),-W, rnt✓. Completion-Stove pipe/christie box <br /> Geologist 01f) W, n F;56L2Br_ <br /> auger o.D. R- ix�,l-���✓s_ <br /> ..user I.D. 4. zS I`n�.leW <br /> SAMPLING <br /> CCA Ill n SQ / K/Y/e'GC�IIr./, <br /> Purasc�( a c°aol�. of}er <br /> Holding Temperature 4 to aeooleY <br /> Method P"eolw <br /> scrae.^.i ng Mzthod ; l 11 be v' eeke- ._ <br /> Lce"Of d Pt� C ire . ABOVE-GROUND <br /> Tracking Sheet 0n) _ 'ON CCMPL-TION <br /> G-W nd Surlxs <br /> SPOILS d <br /> J�"� gra <br /> Storage Method $ 0%fV"+ 3 T 3 ft. <br /> Contamination Noted V yes/(D <br /> Storace Location On. S +f. 5- <br /> m <br /> d <br /> — m <br /> SPECIAL PERMIT INFO. = a- <br /> 0 <br /> slotted c <br /> Distance to sewer line Uri kn obJ-r. sac�on <br /> Domestic well on site - yes gtavelPadc <br /> If _yes, location & distance . __—IL <br /> tt. <br /> ft <br /> GROUTING <br /> MATERIALS USED: <br /> f 0 <br /> 7epth to water /D . 7 (�. Cas;ng type oZ-t nG� SGI..w�oG 4 <br /> ii:< RatiosrhAdt in build eOf411ewi tR"dA4 41 Blank_ ft. Screen i$- ft. <br /> installation Method <br /> "ona 47 lbb4 Slot size 0. 010 in"Cltr's <br /> - efTcjPer-ly Ba s cement nne 49-Ib baAniuillrr�e T at"fir°"+larcol <br /> Zuantity installed l �Q.�'t�. _ Qu�Hre;te. g - <br /> (rt,; n� ^'- -1s bentonite %m of& S-6-1)24tY Nnic plug <br /> 4erne.t}'. Bags sand/gravel S 100-Ib qts-Cem¢X LYI�o'S <br /> Filter Pack tvpe/size U Lug}rte <br /> >tal Billed Time Per Site -Tyle, W n+oYt . 4z. LJkJ h�dreul c L <br /> o-we- hal hoer. <br /> .te Permit Finalized _ __ <br />