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MONITORING WELL INSTALLATION REPORT <br /> Date: 7-6-1-L- CONSTRUCTION <br /> Premise Address:_ 6100 N. H W q q r S4�a4te. Total Depth -7O A <br /> Well No.: SV E _ I Screen Length (from) t (to) <br /> Filter Pack (from) S2 -Pt (to) E <br /> IC Seal BeRfenitt (from) SO A (to) r-Z- fk <br /> Inspector: J. 'P A ICL.m Grout (from) (to) So -f'k <br /> Drilling rig type <br /> Permit No._ S R dy(�- �j Auger O.D. 10 incl, I.D. S. ZS <br /> Completion- Stove pipe/christie box (circle one) <br /> Drilling Company: Cascja <br /> Driller: Tory $F�a2cr casing <br /> height <br /> Consultant A Q CA DTS <br /> Geologist C HV L Q� <br /> ABOVE-GROUND <br /> COMPLETION Cf RISTY4M <br /> SPECIAL PERMIT INFO. Grour)d surface COMPLETION <br /> Distance to sewer line proof <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance - h. <br /> h. <br /> h. 7 <br /> — m <br /> r <br /> SAMPLING — oc <br /> slotted <br /> soc5on ; <br /> Holding Temperature — <br /> Method _ rhes l Sl . ..s Sel sn� fl" d <br /> Screening Method_ prfI T—'—� — <br /> Tracking Sheet - (y/n) _ <br /> SPOILS <br /> Storage Method pro yv MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location_----An n c i ke Casing type ! e C.J ft- 90 PV ' <br /> Blank S1 ft. Screen—AL—ft. <br /> GROUTING Slot size O. o I o <br /> Bags cement <br /> Depth to water 7t7 It Buckets hnst,"&e IC SAj 2 6�r <br /> Mix Ratios Bags sand/gravel 15 ti' f <br /> Installation Method Filter Pack type/size 7IG SS d <br /> Quantity Installed Surge Block: - (y/n) <br /> t Discussed with geologist: - (y/n) <br /> EH 29 29 Type of method <br />