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_• RING WELL INSTALLA r TION REPORT 13 G✓��f�/V as y <br /> MONITO / s 6 s� <br /> CONS <br /> vd <br /> Date: Total Depth (to) 70 <br /> �tj7r from) 't_�� <br /> � <br /> Premise Address: Screen Length ( 7 <br /> Filter Pack <br /> (from)— '13 (t) yp, <br /> Bentonite (Ecom)) i. � <br /> well No. Grout (from) l✓—(CO)~ �� <br /> Inspector- Drilling rig type <br /> Auger O.D. " I.D. <br /> Completion - Stove pipe/chrtsne box (ci*cle one) <br /> Permit No. ��� <br /> Drilling Company. ^ casing <br /> I II heiShC <br /> Driller: iwN <br /> WT <br /> Consultant C/ °M-` E-GRCUND <br /> Geologist COWF ET7ON <br /> —�Grcuc�1 Su1ac/ <br /> SPECIAL PERMIT INFO. gnat <br /> Distance to sewer line ft. <br /> Domestic well on site .- C Y/ t') ft. <br /> If yes, location and distance - <br /> 4 = O <br /> O <br /> _ C <br /> O <br /> 3, n <br /> SAMPLING <br /> Holding Temperarure _ _ <br /> Method — <br /> Screening Method = tt <br /> Tracking Shcet - (Y1 n) <br /> SPOILS <br /> MENT <br /> MATMALS/DEVELOP <br /> Storage Method Casing type <br /> Contamination No[ed - (Y/ n) Blank_ Screen <br /> Storage Location Slot size <br /> Bags cement <br /> GR_ OUTING Buckets bentonite <br /> Bags sand/gravel <br /> Depth to water 6; ,.5 ,l, /'a Filter Pack type/size <br /> Miz Ratios 3 bu 'tn d r. '"t L5t)1eq Surge Block: - (Y <br /> - / n) <br /> �tstallati°n Method ,. Wuf Discussed with geologist: (yType of rncdtod <br /> Quantity installed <br /> EH 29 29 <br />