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,WTORING WELL INSTALLATION REPO}, <br /> 60C1���h'i <br /> Date: Ja f2 Q /til / Q 0 .21;12008 CONSTRUCTION �{ �� <br /> Premise Address: .J D W • �iyt�r+ems- tl(/ Total Depth G°dadue 04' y- <br /> �J Screen Length (from) GO ' <br /> Well No.: FIlter Pack (from) GU (to)4Z_ <br /> r " " Bentonite (from) 1/7 ' (to) S" S ' <br /> Inspector•. V i 0- c rnC 4�/L4 r Ya>✓�I Grout (from) SSS.S` <br /> (to) <br /> Drilling rig type l/iYtE-f3� <br /> Permit No. 005 -2+118 Auger O.D./5;k� a„d R;r.1 I.D. �2 S "�irdi��l <br /> Compledon - Stove pipe trisde .0011(circle one) �� <br /> Drilling Company: <br /> Driller: m,4 UY r' i4 \l casing <br /> I-IL-Og fSt'.rrv/ : JA.t Larr»,- a• t-/ 08 <br /> rYcy At�vjr 7� height <br /> Consultant_ A RG'R I J Q L� 1 ,08atm1 D \ <br /> Geologist T, jqAnrt }�a )I ;nQ6ii)arr� I-)91?6ADiS - <br /> �Or� rri,�n tiller -pRCAt71S ABOVE•GFCUND <br /> COkFLE-r10N <br /> I-IL-08 COWLEnON <br /> SPECIAL PERMIT INFO. 9 t L' pend Surface <br /> Distance to sewer line 10-Yl,S .Z.8 prcut <br /> L Y] �Gn,f/��� 12-13.5 .2.1 <br /> Domestic well on site - (y/Q 14-I5-.5 1,2 44/s S It <br /> If yes, location and distance - If.' 17 0.8 <br /> 17-17,5 0.Gft. <br /> is. 1q,57 0.7 eft• <br /> ve-�L6 0.3 r: _ <br /> 12'23.5 o,4 — <br /> 24-15.5 0.q = <br /> SAMPLING 82815”- <br /> 5"-1 J. <br /> 1 -2828,5 .q �lorad — c <br /> 30 3i.5 OL �orJcn - 8 <br /> Holding Temperature 32 - 33,S o,s <br /> Method 3y-351s 0,5- = pavelpaCK <br /> Screening Method D 35<S 35,5 0.7 <c <br /> 3L — <br /> Tracking Sheet 34.S o,?n ) 38 - 39- 0 ? = <br /> eanhnvov,r IUQA�r++f Ps i I•Sfcc� 3q ft = (�U <br /> 00 G - J 90 y1•S-o,c ft, <br /> SPOILS 42-1713 0,7 <br /> 43-935 0.8 <br /> Storage Method V1 4± 0-9s 0.8 MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y`/6:0) YS-t15' /.3 <br /> Storage Location d"v +-C- 4G-y7 /;,1, sing type ,?-ih. A <br /> 97 yZ -Blank So ft. Screen /0 ft. <br /> Slot size z,e <br /> GROUTING Bags cement <br /> Buckets bentonite / Sd Jr(, �°`�V- <br /> Depth to water 8,S Leif ��a Bags sand/gravel .,S-- FWc <br /> Mix Ratios A err 4n4,5�] �G.,s 47- 161—r(4 Filter Pack type/size -2 /1 Z- <br /> Installation Method_ -TV'e h ' �— Surge Block: . (y 67 <br /> Quantity Installed145 J&AS Discussed with geologist: - Vy-)� n ) <br /> 7 Type of method <br /> EH 29 29 I T 'P).D IRc as 4(, a 0- 25-013 <br /> .1 rnw-Gc is �� <br /> SG -9--7. 3, <br /> L1ne61. �� - s9•s- - 3. 6 <br />