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MONITORING Wr7.L INSTALLA MON REPORT <br /> Date:_42�3 CONSTRUCTION <br /> Premise Address: 20 Toral Dept <br /> Screen Length (from) <br /> �Qd.►�) Filter Pack (from) (to) <br /> Well No.:.. <br /> Bentonite (from) b {to) d <br /> Grout . (from) <br /> Inspector: Drilling rig ryPe <br /> Auger O.D. Z,7-- <br /> Permit <br /> c,z- LD. <br /> Permit No. e/chrisde box (circle one) <br /> Completion-Stove pip <br /> DrMing Company: 0 A--0 <br /> Drillew –f cas^nnr, <br /> Consultant D • T <br /> 1 <br /> AS"`Y�-�ie�OLlh�Q Ci-�iS.Si Y�3CX <br /> SPECIAL Pr_ T INFO. C9r,�tt Su'aa A <br /> Distance to sewe`line <br /> Domestic well on site - (y/ n) ♦ '`if yes, location and distance - tea-` +� <br /> « _ - <br /> alcuad <br /> S•�C n _ <br /> Holding Temperature r�N c,�,' <br /> Method <br /> Screening Method -P i l __ <br /> Tracking Sheet - (6/n) <br /> SPOILS <br /> Storage Method - MATQUAIS/DIrVELOPMEW <br /> Contamination Note - O/ n ) <br /> Storage Location Casing type <br /> Blank 3 S fr. Screen t S fL <br /> Slot size---=o-L O <br /> GR—OL�ING Bags cement N 2� <br /> Buckets beatonire <br /> Death to waterBags sand/gavel -10 <br /> Mix Ratios ✓U 1 C—;sS r� C� Filter Pack typesize <br /> r ( Singe Block - n) <br /> installation Method }t, f�' d�,:�"` ,� �`EC� Discussed with geologist: - (y/ n ) <br /> Quantity Inst fled – <br /> Type of mer-hod <br /> FH 29 29 _ �, <br />