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MONITORING WEU INSTALLATION REPORT <br /> CONSTRUCTION <br /> Date: <br /> Total Depth <br /> Premise Address: Screen Length <br /> Filter Pack (from) <br /> Well No.: Bentonite (from) — <br /> Grout (from) <br /> Inspector: Drilling 63 tYPe <br /> Auger O.D. I.D. <br /> Permit No. Completion - Stove pipe/christie box (tittle one) <br /> Drilling Company: <br /> casing <br /> Driller: Fri height <br /> 'V <br /> Consultant <br /> Geologist ABOVE-GRCUND C tn*Y-3OX <br /> OOWPLE CN coMPLrnaN <br /> Cirnurzi SLztact <br /> SPECIAL PERMIT INFO. ' <br /> gra.rt <br /> Distance to sewer line �,�,{t. <br /> Domestic well on site - (y/ n) ft. <br /> If yes, location and distance - <br /> vr <br /> �A <br /> 0 <br /> _SAM_ PL.ING sxzcn _ <br /> r r_rnack <br /> Holding Temperature r <br /> Method +h" <br /> Screening Method _ <br /> Tracking Sheet - (y/ n) <br /> SPOILS <br /> MATERIALS/DEyEI.OPMENT <br /> Storage Method <br /> Contamination Noted - (y/ n) Casing type <br /> Storage Location Blank----.ft Screen • <br /> Slot size <br /> Bags cement <br /> GR_ OLMNG Buckets bentonite <br /> Bags sand/gravel <br /> Depth to water Filter Pack type/size <br /> Mix Ratios Surge Block: - (y/ n ) <br /> Installation Method Discussed with geologist: - (y/ n) <br /> Quantity Installed Type of method <br /> EH 29 29 <br />