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WIITORING WELL INSTALLATION REPOI.• <br /> Date: jan u4r�. 2,069nnII Gi rYf1hN dd CONSTRUCTION <br /> Premise Address: 509 w, C N.Q✓�✓Liel�2t� Total Depth 3/,S�e� I,ufsehwrll 1 �7�eeJb� <br /> J Screen Length (from)_ 4? ' (to) / 7 ' <br /> Well No.:_ Y/7 G!J ' �} Filter Pack (from) 271 (to) /S' <br /> I // Bentonite (from) /S' (to) 1 3 ' <br /> Inspector ��//4 <br /> . ��PNI�,. �.f I� r hZ 1 Grout (from) 13 ' (to) r,„ -Ade� <br /> t Drilling rig type C M E -8S- <br /> Auger <br /> Permit No. O QS-.24 L 8 Auger O.D. P n,-,Le3 I.D. <br /> ��oo / / Completion - Stove pip /cliristie'b <br /> : / o3 (circle one) <br /> Drilling CompanyASGQlt�C !i ri ��i J �'-- <br /> Driller:p� D r . rr D ( o casing <br /> {3 re�L!re nas R aJM L4rroF height <br /> Consultant A (Re A -P 1S v 4 \ <br /> Geologist_ Bre-+L Kre- b. ; el - A9CAbjjS .- <br /> 1 1 f�any N o I! inJr uJ�r�� -ARCA�IS A80VEGRCUND <br /> COWLETION <br /> comPLETICN <br /> SPECIAL PERMIT INFO. ground Sudan <br /> P I D <br /> Distance to sewer line u n k 0 o i,/„ -R toh' j Ori <br /> Domestic well on site - ( y 4LKT7 10 -r/.S S.� <br /> If yes, location and distance - /s 3.5 1.17 <br /> 1ti-15.5 3.z - j? ft. <br /> lL -17..5 7.q <br /> .72 -23 S,Z- = c <br /> SAMPLING 23,5 4.2- <br /> -2V <br /> •zJV -�S�S 1.1 saricn — <br /> Holding Temperature of A <br /> Method 2g-zq,y D,7 <br /> Screening Method V 1-,D <br /> Tracking Sheet - ( n )&n4-;q,) o ur /dqq nq -4-rm to 3/,S 2 tt _ rl <br /> SPOILS <br /> Storage Method_ V X-,q-t ge t- MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y/�jit ) <br /> Storage Location e, Casing type .,--i nri gni edlu D <br /> Blank 17 ft. Screen /D ft. <br /> Slot size D, D D <br /> GROUTING Bags cement 3 ave r � <br /> Buckets bentonite 1 <br /> Depth to water .27 7 --eef Bags sand/gravel I r mW.-A <br /> Mix Ratios lq-Ib bA 11Na� LU4f�' Filter Pack type/size <br /> Installation Method' r jA11.�,e!r vm Surge Block: - ( y <br /> Quantity Installed -r 11 s 3 b Yah CZm/ Discussed with geologist: - 0/ n ) <br /> d- ted! Ab of t 9 ,tal)n r o '�b Type of method <br /> EH 29 29 e. 0 ro ui I e fid c,re. fry» mud -sA. <br />