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.,MONITORING WELL INSTALLATION REPO__ <br /> Date: Ae /0" '?,00P CONSTRUCTION <br /> Premise Address: l� Alp N Total Depth 7 <br /> zel� Screen Length (from) �3 (to) Gf <br /> Well No.: Filter Pack (from) $S (to) <br /> Bentonite (from) 60601 (to)� <br /> Inspector: Grout (from) 5T(o (to) O <br /> �� Drilling rig type 5 <br /> Permit No. // <br /> C) Auger O.D. $ I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company:, <br /> Driller: 4� f� casing <br /> height <br /> Consultant &_trw <br /> i- t <br /> Geologist AA4"lr—& ' T <br /> � <br /> ,,/� ABOVE-GROUND C_GS Y-BOX <br /> �7"` COMPLETON COMPLE71CN <br /> SPECIAL PERMIT INFO. , 56 Ground Surfacs <br /> /S�3 <br /> Distance to sewer line / ,50 1, 5� grout s <br /> Domestic well on site - ( y n <br /> If yes, location and distance - <br /> ;r: o <br /> SAMPLING sloCad = <br /> Holding Temperature _ V,,W Pack <br /> Method — — <br /> Screening Method = <br /> Tracking Sheet - On) <br /> ft. — ft. <br /> SPOILS p <br /> Storage Method S> 1� � MATERIALS/DEVELOPMENT <br /> Contamination Noted - (�0 <br /> Storage Location Casing type dot <br /> Blank 0 ft. Screen 6d ft. <br /> Slot size , oto,' <br /> GROUTING Bags cement <br /> Buckets bentonite 2 - C <br /> Depth to water ~ .�� Bags sand/gravel <br /> Mix Ratios 4 t Filter Pack type/size V12- <br /> Installation <br /> /ZInstallation MethoSurge Block: - ( y n <br /> Quantity Installed 56 t 3SF Discussed with geologist: - ( ye) <br /> Type of method <br /> EH 29 29 <br />