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T-—NITORING WELL INSTALLATION REPT- <br /> L-001 <br /> EPTL <br /> Date: CONSTRUGTiON <br /> Premise Address: Total Depth 25 / <br /> Screen Length (frown) 20 (to) s-- <br /> ��Well No.: _ Filter Pack (from) <br /> Bentonite (from) 1.5- (to) <br /> Inspector: Grout (from) / (to)_/ <br /> Drilling rig type <br /> Permit No_ Auger O.D. I.D. <br /> Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist <br /> AE&E-GROUND CJ-St 430X <br /> COMPLETION COMPLETION <br /> SPECIAL PERMIT INFO. Gtmund Surface <br /> Distance to sewer line <br /> Qrcut <br /> Domestic well on site - (y/n) - -- ft. <br /> If yes, location and distance - <br /> �. ft. <br /> SAMPLING sbttod G <br /> sacdon <br /> Holding Temperature <br /> Method ` VAVW Pack <br /> Screening Method r <br /> Tracking Sheet - ( y/ n ) <br /> �fL <br /> SPOILS D k'd O j aV���� u1�G /it S1dCc 4tJ <br /> Storage Method MATERIALSIDEVELOPMENT <br /> Contamination Noted - (y/ n ) <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 Ratios Filter Pack typesize <br /> Installation Method Surge Block: - (y/ n ) <br /> Quantity Installed Discussed with geologist: - ( y/ n ) <br /> Type of method <br /> EH 29 29 <br />