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• • <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: <br /> 312 C ' 2 CONSTRUCTION <br /> Premise Address: /(to 'TURN TCF d Total Depth 32/ <br /> Screen Length (from) TJ (to) gZ <br /> Well No.: O Filter Pack (from) 27 (to) 4 2 <br /> Bentonite (from) �A (to) 27 <br /> Inspector: J. VoI ulm Grout (from) 'U (to) Sue <br /> Drilling rig type L(WrrPD QW-s 21F <br /> Permit No. S 200! q SU L• Auger O.D. R' I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: pi-i^ 4JCLL /a pNibN W1Fn7C _ <br /> Driller: go&( T _�jL$G LE casing <br /> height <br /> Consultant A(rET <br /> T <br /> Geologist r)l+ty(Et- Q (W-A AJ C U, AgpyE-GRpInJD <br /> COAFLETION CHR <br /> C PLETION <br /> SPECIAL PERMIT INFO. Ground Surt'o° + �� <br /> grout <br /> Distance to sewer line <br /> Domestic well on site - (y A'D Zy tt. <br /> If yes, location and distance - 30 tt. <br /> ft. <br /> 0 <br /> — o <br /> SAMPLING N4C2osl <br /> Holding Temperature _ = gmV69 Pack <br /> Method <br /> Screening Method . <br /> Tracking Sheet - (y/ n ) 3 Z 4. j 2 <br /> ft. — tt. <br /> SPOILS <br /> Storage Method IJtN r�ruif MATERIALS/DEVELOPMENT <br /> Contamination Noted - Cg n ) (� " PUc+ <br /> Storage Location 0012('7c - I RwuT Casing type <br /> Blank 2( ft. Screen AZ=3 ft. <br /> Slot size MtQRo Pog <br /> GROUTING Bags cement 4r 9N.as <br /> Buckets bentonite /I x 50 ' J�uRE�socDMSOru <br /> Depth to water ti 17 Bags sand/gravel $r 4?LO <br /> Mix Ratios 41 UeK /3 a7 <br /> a�m6 " Filter Pack type/size �9 x I! sRy D <br /> Surge Block: - (y/(P) <br /> Installation Method TRiw„ron g <br /> Quantity Installed___-L4o Discussed with geologist: - (y <br /> Type of method <br /> EH 29 29 <br />