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MOICTORING Vr3r 1..INSLALLA.LION REPORT <br /> Date: CONS'T'RUCTION _ <br /> Premise Address: 1.1 G-�, c-^ - -- `ak-'14 Total Depth 's , (to) IS' <br /> - <br /> Screen Length (from) c _ <br /> well Nom Y►ti tin? -3 Fli ter Pack • MOM)+ £C (to) aS' <br /> Benmaite (from) (to) <br /> t� _ Grout (from) (to)= <br /> Inspector. •��a'- - , <br /> DnUing ng <br /> LD <br /> Pe-*mit No. D 1 y Anger O.D. 2;Y-1 <br /> CompleTi=-Stove pipe/criristie box (circle one) <br /> Dnlling Company. L'-,f-zn(M16dioL - <br /> �_ casing <br /> Drsller: �^�t���p� ._ . . o ♦ 4a:ght _._ <br /> 7 f <br /> T <br /> Consuirant C' l - � �� <br /> 1 <br /> Geologs: , <br /> A3-,VS-6XRa MD ��-acx <br /> , <br /> SPECIAL? VR'�INFO. Gc�cttiC S�ztxa <br /> Distance to sewer line <br /> Domestic well on site - C y/ n ) <br /> If yes, locarion and distance - n- <br /> SAMp1ZNC :s°cad r 0 <br /> _ Holding 7exxxperature A - - <br /> Vzvoi packMethod r, <br /> Screening Method <br /> T:ackng Sher: - �/n) <br /> =_ _ a ly IL <br /> SPOILS <br /> Storage Merhod SS �uc-� An L4 V^, MAT-gUALS/DEVBLOPMQN i <br /> Contamination Noted - (y ) Casing t9Pe ` PV& <br /> Storage location Bl k I p fL Screen - l" - fL <br /> Slot ssze . O�-� <br /> GROUTLNG Bags cement <br /> Buckets bentonite z <br /> DeDth _ Bags sand./gravel <br /> Mia Ratios tL Filter Pack typesize ' f Z-,-eV—cJ2 <br /> Insm larion Method Stage Block - C y/ ) <br /> Quantity installed <br /> Disccsse:d with geologist. - n) <br /> Type of method _ <br /> E.^I 29 29 <br />