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- MONITORING WELL INSTALLATION REPORT ` O / <br /> Dace:_ ;-,oD CONSTRUCTION <br /> Premise Address: '9'D MCl i n ��freef" Total Depth_ 8$ f C_e_� <br /> Screen Length (from)_ 18/ If (to)_4/ " <br /> Well No.: M W - I Filter Pack (from)_ 85 ' <br /> Inspector. _ V�k N I e--C/4 r�Yl.e-ca Bentonite (from) 576S`8 i0 ' (to)�� <br /> Grout (from)_ � 8 (to) Sof att <br /> Drilling rig type G M '9 '75` <br /> Permit No. 0 'J$ Auger O.D. 8-;n I1QS I.D. t- 41 ;,,C -e <br /> Y) Completion - Stove pip tnsae box ircle one) <br /> Drilling Company:- 4fa S e-dj:Ze- <br /> s'r ��i r� (� <br /> Driller: j2u casing <br /> y Ass;S tantJ �'�94n Gv+ n ; Aaron �qv�'s 7F height <br /> Consultant 0 0/7.,W <br /> Geologist Jo M . <br /> _Ro)9" }- fnar vTs;>`c"Oe e- t,4-c- f.°aYE G�CUND <br /> CG W LETfO N Ck-:R ZTY•n0 X <br /> SPECIAL PEIRNii'C INFO.l - Cx-�'-ids tsiact <br /> Distance to sewer line rt ofCrn v w� ��1. fl1xZ <br /> Domestic well on site .- (y/ rUi ) <br /> If yes, location and distance - <br /> = o <br /> SAMPLING = <br /> Holding Temperature <br /> Method 1/210 d Iez,- -f —j G-e- <br /> Screenin;Method P I D <br /> Tracking Sheet n ) <br /> .j <br /> A V t:. <br /> SPOILS -To+a I De���1 8 s � < <br /> Storage Method_ S o o�G ,co( U.n V►'S�t Ur?�� _MATE RIALS/Dn'VE(.OPMENT <br /> Contamination Noted - <br /> Storage Location_ s+o mak-A;1 z u-- s,+e Casing0type Se. 40 <br /> BIank Screen 2n K• <br /> Slot size O, <br /> GROUTING �� WS, }S Hags cement 3 ov k <br /> Jo »1e:4Juru��` 4,0e.• 4Z"41 Jni•F;ui�,� EuCkets benronite _ c'nv�voplv9 <br /> Depth to water 13 beef ( A�.�,Pt at' 'j0-7S-fe la.' � ags sand/gravcI 10 0-P0,0-.01 S L <br /> Mix Ratios_ 8 +6 Q 47;oou'rJ WAS Ce � ?.r4,4//MS ofcciafe•-�dter Pack type/size # 3 <br /> us arc <br /> iBstallation Method 6 r �fSurge Block: - (y n <br /> Quantity Installed 3S Por khan-o(Discussed vrith geologist: - n <br /> T -�- g- ck enc �& M;,< Type of method <br /> �., S yY1 ar x . - $ra�•�l"TXI Ile <br /> EH 29 29. 3o.,tfrK:}� - 3/g "Ch <br /> ftp r.. rn, <br /> �" ba`Fch e S --1-o-1-a I - �i a}t�.as ►, 2,3 W c r �►,adL W; 8 b S C int G,c,t� 3 s'e ll r�µ:b <br /> � w; 1764- <br />