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MO' `RING WELL INSTALL.XTi0N REPORT <br /> Dace: -7— l J 1 _ CONSTRUCTION <br /> 2,0 Total Total Depth 53 <br /> P-1-mise Address:: Screen Length (from) 5D (to) 3S - <br /> I` 21 I� Fate.- Pat's (from) 53 (to) <br /> Well No.: <br /> Bentonite (from) 33 (to) <br /> i= <br /> Grout (from) (to) 'O <br /> Inspector• <br /> Drilling ;ig type arc_20� T w <br /> Permit No. Auger O D. /?�" I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company. _ <br /> casing <br /> Driller: I AF— height <br /> c. . <br /> Corsultan <br /> Geologist s �VE."FtCC,NO CH STY-3CX <br /> CrM?'�SCN C:MP:_=CiCN <br /> Ground Sutxs <br /> S?°Ciai ?;;:. INFO. I Stat <br /> Distance to sewer line 1 3C tL <br /> Dor..esdc well on site - (y/ nt- <br /> If yes, location and distance - ,.. ft. <br /> " — 3 <br /> on <br /> I MC <br /> 0 <br /> tIOILQd �% — o <br /> S IPLING <br /> HoldLna Temperature <br /> Me:.?ed <br /> Sc:eening:Method t D <br /> Tracking Sheet - (y/ n) SO ,� ♦ ~ — ft. <br /> SPOILS <br /> Storage Method MATE'E'IALS/DEVEL OPNENT <br /> Concarnination Noted - (y <br /> Casing ryPe <br /> Storage Location ft. <br /> Blantt 35 ft. Screen 1 S <br /> Slot size O 2— <br /> GROUTING Bags cement �C <br /> O-D <br /> Buckets be.ntat� EDaad <br /> Depth to water g l Bags sand/gravel <br /> f Z 3% T G� Filte-*Pack type/size lC <br /> Mi.Y Rados l Surae Block: - C Y <br /> Ins-.alladon Method <br /> Quantity Installed 6V /k�� Discussed with geologist: - ( Y/ n ) <br /> Type of method <br /> ��/ 13 �� i <br />