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MONITORING WELL INSTALLATION REPORT <br /> Date: W zcj/201 <br /> CONSTRUCTION <br /> Premise Address: 1--450 W,V to. Ni to10 PA, Total Depth 125 <br /> Well No.: MW-35K Screen Length (from) 11'7- (to) 127- <br /> Filtet-Pack ' (from) I/S (to) 128 <br /> Inspector: ,�. �OpKltbl Bentonite' (from)_ 112 (to) <br /> Grout (from) V (to) 112- <br /> Permit <br /> 12Permit No. SR 00-+05 1-::f- Drillingrig type-, CMB SS <br /> Auger O.D.— V - I.D._ 4•.95 <br /> Drilling Company: V W Completion tove pi christie box (circle one) <br /> Driller:_ 'V-fA')k kwy�'r(t <br /> casing <br /> Consultant Ter�0. ase height <br /> a �t�ee*1^y,s��. T �sF+. <br /> Geologist �tJpv�-Mon}c�OmC(y - <br /> ABOVE-GROUND <br /> COWLETION CHR1M-BOX - <br /> SPECIAL PERMIT INFO COMPLETION <br /> Ground Sidacs <br /> Distance to sewer line grout <br /> Domestic well on site - (y/n) <br /> If yes, location and distance - !12 - ft <br /> — e - <br /> SAMPLING c <br /> 0 <br /> ■bttad <br /> Holding Temperature <br /> Method _ � <br /> Screening Method = <br /> Tracking Sheet - (y/n <br /> SPOILS ) ' <br /> !28 � ft. <br /> Storage Method MATERIAL,S/DEVELOPMENT <br /> Contamination Noted - (y/n) <br /> Storage Location Casing type -Sc6eavie $0 PVC. <br /> Blank 120 f[. Screen I c ft. <br /> GROUTING Slot size o.o t0 <br /> Bags cement 2H <br /> Depth to water Buckets bentonite 2 <br /> Mix Ratios Bags sand/gravel_ <br /> Installation Method Filter Pack typesize 2/1(p <br /> Quantity Installed <br /> Discussed with geologist: - (y/n) <br /> EH 29 29 Type of method <br />