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.MONITORING WELL INSTALLATION REPOn . <br /> p ✓U lrti� 8q y CONSTRUCTION <br /> P4tvrts-e Address:. '^ ' 7 �`i 'fiB U _ Total Depth <br /> Screen Length (from (to) O _ <br /> Well No.: Filter Pack (from) <br /> Bentonite (from) 53 .(to)� <br /> Inspector: - Grout (fro cc Ce (to):Z l <br /> Drilling rig type_ <br /> ?f/� (OV —r�— <br /> Permit No. Auger O.D. � o I.D. Sty _ <br /> /J Completion - Stove pipe/christie box (circle one) <br /> Drilling Company: � �'/ <br /> Driller: casing <br /> height <br /> Consultant <br /> Geologist,- V <br /> A80YE-GROUND CHRISiY-90X <br /> COAPLETION COMPLETION <br /> SPECIAL PERMIT INFO. ®-a --®�-- Ground Surixa <br /> Distance to sewer line N!B 0r <br /> Domestic well on site - y n ) / �A �s <br /> if es, location and distance - �l_ k. <br /> •- --- - - ft. d r: � t <br /> a <br /> SAMPLING stoned <br /> G &@tion — - <br /> Holding Temperature0MV64 Pack <br /> Method — P <br /> Screening Method <br /> Tracking Sheet - ( y rt )_ <br /> _..__ft. I�M <br /> SPOILS <br /> Storage Method `�'� 1 d" " MAIC ALSIDEVELOPMENT <br /> Contain nation Piloted - n ) 1V 9ll O ` �� go <br /> Storage Location O� Casing type <br /> Blank /D ft. Screen ZO ft. <br /> Slot size - Oto " <br /> GROUTING Bags cement <br /> Buckets bentonite <br /> Depth to water = �� dm4t) VLU eL 101irags sand/gravel iM4 7, <br /> Mix Ratios // ✓ U Filter Pack type/size_ YJ <br /> Installation Meth d 6JAAwc- 4rS ..9�a"fAc to Surge Block: - ( yam] <br /> Quantity Installed rZS �ae-� u _ Discussed with georogist: - ( y �n <br /> Type of method <br /> EH 29 29 <br />