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.NITORING WELL INSTALLATION REPOS. <br /> Iii/OB �Ufe0� �arsetf• <br /> Date: �a vt1�ZDd 8 Q Ldl oma•as zoo 8 CONSTRUCTION -4Gu svea <br /> Premise Address: SO Total Depth Sleet <br /> Screen Length (from) 6 d (to 5-D <br /> Well No.: IOWA(I - A e(- Filter Pack (from) GU (to) So7.9 <br /> 1/ L ,L� Bentonite (from) 47, 9 (to) <br /> Inspector. _ V�P�kC r /cam. C Y>-)2�L. Grout (from) (to) Surf6e� <br /> Drilling rig type C t-,Pe -8S <br /> Permit No._ Auger C.D. iS-brdti-Ai>,6,4 I.D. �n <br /> Completion - Stove pipe/cltrt e ox ircle one) <br /> Drilling Company: �A.I/��� �/�, /�i` <br /> O <br /> Driller: ogwg61/er .i r/ oqaoe casing <br /> ,_rr• <br /> 1--Is%ov dxrfri` /Lt., ' J -rrh- 4rJrr, d- 7.YJ�t�rtl height <br /> Consultant ./ARC A D !S RBL `m ✓ r �s' �8 IV <br /> I-IS -ut3b 1/ )oe - -"r�'lo,hgt <br /> Geologist 71 run ��,` �.-C/�or`y� ��C��/7 <br /> I- IS•o9 Q - / _ �}t>?L f}�/,j ABOVE-GRCUNO <br /> I zs a8 ��}} CONFLETION COMPLEnOX <br /> f f �r l� lti' rehb)•e� - ARcAD.Ts I-lS•o9 cot.+PLencN <br /> SPECIAL PERMIT INFO. p I D Ormond Sufacs <br /> Distance to sewer line d peJ orwt <br /> Domestic well on site - ( y/0 (0 //,S C,t <br /> If yes, location and distance - /2-/3S v, 3 7 sft, s; <br /> /4-/s,r r,, I d 7, ft. 1 _bua <br /> 2cQOl)v+� 9 r7.j L.s <br /> 1 o so-sl, o, iy-;rj G,7 = <br /> 52-53.r 0. 86'Pm IQ •i`1.5 �`-- <br /> sY-SSS <br /> SAMPLING 3G _ 59.r 0,7 — <br /> S8 -s'9•J �-/ oy 2-23 z ween <br /> AA <br /> Holding Temperature 23-23,5 3.G <br /> Method 2� _.2S = yravelpadt <br /> 2.,7 <br /> Screening Method — <br /> Tracking Sheet • (y/ n ) <br /> Cod;n d vs /ory�i� 6Ve---5 /.sfe�-. J?-.2�s c.s�n. <br /> 0 <br /> SPOILS ,29- <br /> 30 3/.S C.s" <br /> Storage Method flajt o I/, Ste.Po 32-33 1,6 MATERIALS/DEVELOPMENT <br /> Contamination Noted • (y/ n ) 33 33,5" C,E <br /> Storage Location rn-al i P 3�-35" c'.7 Casing type - I n/� cSrSLJG6{/ i�V <br /> _ -V ft <br /> Blank 5 . Screen <br /> 3� 3S'� `'? Slot size 0, 0/ U ) <br /> GROUTING 3(,-37.5 4-/ Bags cemen 1-2,7-°8 / -q?-Ib <br /> lT S� <br /> 3S/-3",)G,S'Buckets bentonite plv�i <br /> 4c-4/,s 0,G d <br /> Depth to water 9z_'ys3 <br /> 1 Bags sand/gravel <br /> Mix Ratios SI� R b sX7. fFilter Pack type/size L ,LZ <br /> alef / <br /> Installation Method s <br /> e (,Surge Block: - O/ n ) <br /> Quantity installed 42 M44 C}7 b X ,-45J 0,/Discussed with geologist: - ( y/0 <br /> S,V-Type of method <br /> EH 29 29 00 71 - <br /> Cbr; fly ` A`'� <br /> 9r0k4'4.' '��'• 1 W s�a <br /> ha <br /> d;re <br />