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r1ONITORING WELL INSTALLATION REPO.2 <br /> Date: 16/2 k/da'> CONSTRUCTION <br /> Premise Address: P Z AJ. � D — Total Depth <br /> Screen Length (from) 2 (to) <br /> Well No.: Dl/►� l ��/' �i- Filter Pack (from) Z5 (to) <br /> Bentonite (from) (to) . <br /> Inspector: Grout (from) t (to) 3 <br /> J ` Drilling rig type <br /> Permit No. ! Auger O.D. g I.D. <br /> Completion-Stove pipe/christie box ( Trcle one) <br /> Drilling Company: �/ -D <br /> Driller: f v��"- 74- casing <br /> height <br /> Consultant �C44�01, <br /> -7�- <br /> Geologist •- Y <br /> ABOVE-GROUND CNRJ57Y-BOX <br /> COMPLETION OMPLETiON <br /> SPECIAL PERMIT INFO. Groun4Suface <br /> Distance to sewer line ? grout <br /> Domestic well on site - (y/ n ) <br /> t• <br /> If yes, location and distance - /pp tt <br /> o o <br /> C <br /> SAMPLING clotted '>? <br /> section = <br /> Holding Temperature __ <br /> Method " P <br /> Screening Method = <br /> Tracking Sheet - (y/ n ) <br /> J •.a y- <br /> SPOILS <br /> Storage Method !�'� / 5 MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/n ) 2�► ��� <br /> Storage Location Casing type <br /> Blank /S ft. Screen /O fL <br /> Slot size <br /> GROU'T'ING Bags cement <br /> Buckets bentonite <br /> Depth to to water Bags sand/gravel <br /> Mix Ratios.. 411 Filter Pack type/size 3 <br /> Installation MeYhod Surge Block: - (35j <br /> Quantity Installed4-1 ZZ <br /> Discussed with geologist: - (y n) <br /> Type of method <br /> EH 29 29 <br />