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'..IONITORING WELL INSTALLATION REPO. <br /> Date:- CONSTRUCTION <br /> CONSTRUCTION <br /> Premise ddress:49aS ,dr&&29 ,PLAgr, _ ST Total Depth <br /> A6 Screen Length (from) (to) <br /> �- elh�trr Filter Pack (from) (to) <br /> —1 Bentonite (from) (to) <br /> Inspector. _ �'+eiG � V1� Grout (from) (to) <br /> Drilling rig type <br /> Permit No._ S�c7!541 3 Auger O.D. I.D. <br /> Drilling Company:,/ <br /> Completion - Stove pipe/clu-istie box (circle one) <br /> � �t' p,�l <br /> Driller: casing <br /> �1� \ - � <br /> Consultant-lb- 'G C-� VieD/ Ei�,-j-�/ height <br /> Geologist4- <br /> I�AAI Ayrz e AD, 2 6.- .. <br /> ABOVE-GACUND CNASSTY-80X <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surface <br /> Distance to sewer line omit <br /> Domestic well on site - (y/ n) <br /> If yes, location and distance <br /> ft. <br /> SAMPLING <br /> aac�cn <br /> Holding Temperature N <br /> Method ''' — QMVW Pack <br /> Screening Method — <br /> Tracking Sheet - (y/n ) <br /> - — <br /> ft. .w = ft. <br /> SPOILS <br /> Storage Method_ t5�G/lwr fli�,v�cs _MATERIALS/DEVELOPMENT <br /> Contamination Noted <br /> Storage Location Casing type <br /> Blank ft. Screen ft. <br /> Slot size <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water Bags sand/gravel <br /> Mix Ratios7,.5% „ , Filter Pack type/size <br /> Installation Me*hod G•A4Vi Surge Block: - (y/ n ) <br /> Quantity Installed_2 Discussed with geologist: - (y/ n ) <br /> EH 29 29 Type of method <br />