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SNITORING WELL INSTALLATION REPO* <br /> Dai - o✓eeoas <br /> Date: Ma re 1, 271 d 12_ CONSTRUCTION <br /> Premise Address: G O 1 Turn✓J IC✓ ( , Total Depth <br /> Screen Length (from) 20 (to) <br /> Well No.: 6V-2, Filter Pack (from) '.L l (to) <br /> Bentonite (from) (to) 3 <br /> Inspector: Grout (from) 3 (to):,--V '- t� <br /> Drilling rig type L,,wJ-4.q1 Alodeuj li';a�7s- <br /> Permit No. 51R } n (j Auger O.D. /0 i'w I I.D. —� <br /> Completion - Stove pipe/ stie o (circle one) <br /> Drilling Company: A/� � <br /> /�/o`� �j�n �yyp� <br /> Driller: �1\d19L t" Se'21- �zTT� casin <br /> , On SaQ'21-e— <br /> o-ee. — T height <br /> Consultant A(,' IF- ♦ T <br /> Geologist14ni-eJ V ��Qn(/�✓, E - T <br /> ABOVE-GROUND <br /> 1Si7-BOX <br /> SPECIAL PERMIT INFO. COff'LETION Gnxmd Surface C <br /> Distance to sewer line I o grout <br /> Domestic well on site - (y/0 �fl 2,,$ 1 N3 tt <br /> If yes, location and distance - I a O tt <br /> Ott. <br /> - m <br /> — a <br /> — m <br /> SAMPLING 570-1'j 50 Imo' I'll' I Blotted = 8 <br /> Z'jw�e&i-s� ✓ ix E via taction '< — <br /> Holding Temperature 16C 4✓4+/,l��/ <br /> Method <br /> ": grt„a� <br /> �L4- 'I ,� �+�, _ . <br /> Screening Method <br /> Tracking Sheet - y/ n) <br /> 0�0 ft. = tt. <br /> SPOILS 7-6tra olep*k a.I <br /> Storage Method y.ns /irr-61' r MATERIALS/DEVELOPMENT <br /> Contamination Noted - y�3 ) <br /> Storage Location Ta 1jrdr mac, Casing type 9 Pr/r-- Se� <br /> Blank S ft. Screen 15-- ft. <br /> Slot size d, nzd <br /> GROUTING Bags cement <br /> —aStbs-Buckets bentonite UrP QD ld <br /> Depth to water "' I7Bags sand/gravel 9 Yxy-/6 <br /> Mix Ratios Q✓ C GZf �P!--Zilter Pack type/size -el rs urrrc_ <br /> Installation ethod �¢If��Surge Block: - ( y n <br /> Quantity Inst led {T__ dY Discussed with ge ogist: - ( y6l <br /> Type of method <br /> EH 29 29 ,pass. `{1 <br />