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• � i <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: 4-24- 20%2- CONSTRUCTION <br /> Premise Address: 301r, Naw 7 v-W* 4 SCOLOMA)CA Total Depth 90 �F <br /> Screen Length (from) 40 (to) 9 a <br /> WellNo.: Filter Pack (from) Y1 (to) 90 <br /> - � Bentonite (from) 75 (to) <br /> Inspector: Tt J - I�rAS 1O T10 U{Vo 5 Grout (from) 2 (to) <br /> Drilling rig type G1. Ig 9S <br /> Permit No. n �`� io 1 Auger O.D. $ " I.D. � <br /> y� Completion - rove pip christie box (circle one) <br /> Drilling Company: C acCaeUc <br /> Drfllet: S Al L :Z a✓ casing <br /> _ �51� height ' <br /> Consultant EY�yl�h}vlan�� t u�Gt.. Trtt 2 T <br /> Geologist M Ike <br /> ABOVE-GROUND CHR75'TX80X <br /> COMPLETION <br /> COMPLE'nON <br /> SPECIAL PERMIT INFO. Ground Suet <br /> Distance to sewer line 2"a f4' grout <br /> Domestic well on site - (y ) .l. -q.5 . ft <br /> If yes, location and distance - <br /> ft. <br /> P <br /> SAMPLING wlor� slotted 'a _ S <br /> q lYv� ascIon <br /> Holding Temperature' <br /> vavol pack <br /> Method 1na..d avcsr vii Si. ois ' _— <br /> Screening Method —T <br /> Tracking Sheet - (y/ n ) <br /> SPOILS l <br /> Storage Method ONS Volt-04& b MATERIALS/DEVELOPMENT <br /> Contamination Noted - &n) f� <br /> Storage Location vU*J,%. %%A. OT S$%- Casing type Sclm-We W Nc p 2." <br /> Blank $0 ft. Screen 10 ft. <br /> Slot size 0.01 -( a'h <br /> GROUTING Bags cement ?27- `1 1 <br /> Buckets bentonite1 S0- <br /> Depth to water `t' -f'F Bags sand/gravel $ vre.L6 <br /> Mix Ratios 941h 15-tel e Filter Pack type/size Nnewl1av4y 'a?.& <br /> Installation Method 'atCnnnn.o Surge Block: - (®/ n) <br /> Quantity Installed Discussed with Type ofmethod gSlrw- Q SvY <br /> EH 2929 a^� <br /> 5 <br />