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ONITORING WELL INSTAUA77ON REP'n' <br /> I <br /> Date: 13 CONSTRUCTION <br /> Premise Address: ID-4 e- �=e_AALk Total Depth 6 <br /> Screen Length (from) VZ_ (to) q! <br /> Well No.: Uw Filter Pack (from) 1 Z z- –(to)�_ <br /> Bentonite (from) S (to) (o <br /> Inspector: Grout (from) !o __(to)_ n <br /> Drilling rig type <br /> Permit No. Auger O.D. �5'f I.D. r <br /> Completion - Stove pip;�e o (circle one) <br /> Drilling Company:_ 131`E 7D�''I I Ill 5 <br /> Driller` ��'l`' nscu�5 <br /> height <br /> Consultant 5 <br /> Geologist <br /> m ��e2 <br /> A80NE-GROUND CHAWY43OX <br /> CONFLETION COMPLEIICN <br /> SPECIAL PERMIT INFO. C3=nd Surface <br /> Distance to sewer line r grout <br /> Domestic well on site - (y/ <br /> If yes, location and distance - �. <br /> tt. <br /> ^a- a <br /> vA A <br /> SAMPLING - slorsd ;f C <br /> sacion F' <br /> Holding Temperature acLeA <br /> Method t — <br /> Screening Method_ OJ �• <br /> Tracking Sheet - (ffY n ) <br /> .x: <br /> SPOILS <br /> Storage Method r- MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/ <br /> Storage Location Casing type 2 PVC <br /> Blank 9 ft. Screen ft. <br /> Slot <br /> GROUTING . Bags cement <br /> Buckets bentonite <br /> Depth to water .�] Bags sand/gravel <br /> too a, <br /> Mix Ratios _ Filter Pack type/ ize `A <br /> Installation Method Surge Block: - y it ) <br /> Quantity Installed Discussed with eologist: -(g/ n) <br /> Type of method <br /> EH 29 29, l!p' 0 P ®� Wro�_ <br /> 14.6 <br /> P �aA <br /> 9.0 apQm 'rJ <br /> &+r 3 Ff'►^ <br />