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MONCCORING WELL INSTAII ATION REPORT <br /> i,.Q�Y er S UC.)�tw 04t v��s!WC6� CayK� <br /> /V� ��'C /l.L{� -� hl�s��h 2=iwck Sr�ulc..Fi.+t <br /> (opN•J04� � aFCps• �''�Oji 4,s.3 , <br /> l CONS 0`T <br /> Date-"�� l�s/ <br /> 93� Total Depth <br /> Premise Address: Sween Length (from) o�—(to) 79 _26 <br /> Filter Pack (from) to 7�` 7e <br /> f / Bentonite (from) 7- /3 C ) <br /> Well No. f (to) <br /> / Grout. (from) 7 <br /> �� <br /> Ir. Dnlh <br /> nspectong ng type LD. � — <br /> �D AugerOD. j�U cl . <br /> Permit No. Completion - o �tnstie box (circleone) <br /> Stve pipe/ <br /> Drilling Company: " casLnq <br /> y�y�CS � he-qht <br /> Driller: <br /> Consultant <br /> dG <br /> Geologist ���yJ� � &!;;VE-GRCUND C}R S{Y ACX <br /> CCWPLEETiON GCMp'L--• ICN <br /> /lelv���l , 5k4ldd/��f <br /> SPECIAL PERMIT INFO. a 'yD l 116'9 -I-Ii#YOran <br /> Distance to sewer line g, <br /> Domestic well on site = C Y/ n) — <br /> if yes, location and distance - _ <br /> — - m <br /> - = o <br /> = a <br /> socicn <br /> SAMPLING = 4rswlpadt <br /> Holding Temperature =tie = <br /> Method <br /> Screening Method — ft. <br /> Tracking Sheet - (Y/ n) —f<• — <br /> SPOILS ,,,,.rM S S_/DEVELOPMENT <br /> Storage Method Casing type /I/C -e- <br /> Contamination <br /> e " <br /> Contamination Noted • (Y/ n) Screen <br /> Storage Location Blank- —h <br /> Slot size /3 6 <br /> Bags cement <br /> _ OVLING Buckets bentonite <br /> GR <br /> Bags sand/gravcl <br /> Filter Pack type/size <br /> Depth to water gorge Block: - (Y/n) <br /> Mi:t Ratios Discussed with geologist: - (Y/ n) <br /> .installation Method Type of rnethod <br /> Quantity installed <br /> EH 29 29 <br />