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E, <br /> w - MONITORING V&U INSTALLATION REPORT . <br /> _j <br /> Date: CONSTRUCTION <br /> Premise Address: 32 12 N, kill- <br /> Total Depth 4Q e <br /> is Length (from) O '_ 1' (to) Z <br /> Well No.-'` V VV - r e �� y , � �w¢�� Filter Pack (from) 4 {to} 3 <br /> Y a .Bentonite (from} r (to)~ <br /> Inspector: Group (From <br /> )�±�_ "(to) f 4 O_ <br /> Permit No. _ * _ d (� �3 7 Drilling rig.type -(r <br /> -- Auger O D. I.D.�lL <br /> ' + - Completion - Stove pipe/clu stie'bos (circle one) <br /> Drilling Company: �Y� 1 r; _ r <br /> Drille S 221 <br /> Jae e I ng <br /> he-;ght <br /> Consultant A ez-o —a .s .st4ez�- IFMI <br /> � he?ght <br /> -- IV <br /> Geologi <br /> URS Sl494t4-�andSafe D0;ceY-TarakG4 Jam AZO E-GRCUND <br /> COt,PLETiON ' <br /> LMS Corlst#`'VeA;o,, Forc.�rt -NeL5#vtM: eros --nc� <br /> SPECIAL PE€ NUT INFO. Ground Skalacr <br /> Distance to sewer line_.. '-V 40 -�ae <br /> Domestic well on site.- ( y/(j <br /> If yes, Iocation and distance <br /> M <br /> SAMPLING _ • a <br /> fIOC.4,i � c <br /> tacicn - <br /> Holding Temperature 40 — <br /> Method — Sxawt k <br /> Screening, Method P D - `� ' =►- _ <br /> Tracking Shcet <br /> SPOILS _ x <br /> Storage 'f <br /> Method_ C9VrAid ) i�ad b in � .a.. I' <br /> - � MATERIAIS�E.OPMENT <br /> Contamination Noted - (y/V . <br /> Storage Location C. a Casing type Ldhedule, 1-0- E! <br /> Blank fr. Screen ft. <br /> Slot size j el <br /> GROUTING • R i Bags cement - ] <br /> Buckets bentonite s 0 �j <br /> Depth to tivater f S� Bags sand/grave <br /> R+YIC.P <br /> Miz Ratios - IIF"-i•5 5d&)/A�dter Pack type/size •� PRrlfr� <br /> -installation Method C td1�f•'s-s- Surge Block: - (y/�1.. - <br /> QuantityInstalled Discussed with geologist: - (412Y n} <br /> Type of method ' <br /> EH 29 29. <br /> + n <br /> . t <br />