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Mor'" (RING WG.-LI.INS'ALLA 10N R. .PORT <br /> Date: -/3 93 /�i5 CONS'T'RUCTION <br /> Pre:r:ise Address: 77� f # - Total Depth_ _ 90 <br /> Screen Length (from) (to) S <br /> Well No.: <br /> �7 3i J Filter Pack (from)_ O (to) 73 <br /> Bentonite (from) �_____(to) ill <br /> Inspec-or. Grout (from) 71-70 (to) <br /> Drilling rig type A41 <br /> Penrtit No. oy13g-'q Auger O.D. toy <br /> Completion- Stove pipe/chrstie box (circle one) <br /> Dr:Iling Company: VLr <br /> / casing <br /> Driller-_ � F height <br /> Consultant A 14 -7//" 6 <br /> r/ - <br /> Geologist A—;ZVEwFICUND CHEZ Y-aCX <br /> Cvki� =►JCN C MPI---=C1CN <br /> Cxound Sul s <br /> SPECIAL PER-NIIT INFO. grout <br /> Distance to sewer line N 71 ft. <br /> Domestic well on site - (y n 3 fL <br /> If yes, location and distance - , 75 ft. -_ <br /> siottad <br /> SA�IP►TNG skion <' <br /> VRVV1 <br /> pack <br /> Holding T emoerature . <br /> Method _ <br /> Screening Method <br /> Tracking Sheet C I n) 'K — ft• <br /> SPOILS <br /> Storage Method Oh-f ��2 �s,�•-- MA 1"RIAT.s/DEVELOPNLNT <br /> Contamination Noted - ( Y n) <br /> Casing type <br /> Storage Location Oyt .d��� Blank '� 7 fL Screen• /S ft. <br /> Slot size -O v <br /> Bags cement / 4> et e2 3 <br /> GROUTING Buckets bentonite <br /> Bags saad/graveI <br /> Depth to water �� Fdte.*Pack type/size �-3 <br /> Mie Rados t <br /> Ins.alladon Meth d ..� Surge Block: - �' n) <br /> Quancty Installed �`fd G Discussed with geologist: - (p' n) G � <br /> 07 Type of method <br /> /z- / s-2 3 <br />