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M'TORINGWELLINSTALLATION REPORT <br /> � <br /> S <br /> Elate: _�3 CONSTRUCTION <br /> // <br /> Premise Address: s• Total Depth_ lO Y <br /> Screen Length (from) (0d (to) b <br /> Well No.: l Filter Pack (From) 60 <br /> Bentonite (from) 3g' -(to) <br /> Insuector <br /> to)Insoector: Grout (from} 5.(. (to) <br /> Drilling rig type 7 <br /> Per:niz No. 3' O�(v 7 �` Auger O.D. 6 YI.D. y <br /> Completion- Stove pipe/chrsstie box (circle one) <br /> Drilling Company: <br /> _ casing <br /> Driller. f '� height <br /> Consultant <br /> ,�QiF_-Gr�CLIND \ <br /> Geologist CNRtS;Y-3CX <br /> G1tvP►,�t 6CN :MFLE.i 1CN <br /> Gnmmd Sutac* <br /> SPECIAL PE�LkQT INFO. <br /> grout <br /> Distance to sewer line ft. <br /> Domestic well on site - (y/(9 g <br /> If yes, location and distance - — - <br /> ,ys q <br /> mora!Pack <br /> Holding T1 emperature <br /> Method <br /> Screening Method <br /> Tracking Sheet - 6J n ) 6[) f <br /> SPOILS <br /> Storage Method MA i_RIALS EVELOPNENT <br /> Contamination Noted - (y/ n ) c/ t'( <br /> Storage Location Ovt Casing type <br /> Blank q.O f[. Screen Zb ft. <br /> Slot size WO <br /> GROIP.-ING Bags cement <br /> Buckets bentonite l + <br /> Depth to water"� Bags sand/gravel12- <br /> ,Mix <br /> 2 ' <br /> Mir Ratios D l Filter Pack typesize 3 G 5 <br /> Installation Method Surge Block: - &/ n ) <br /> Quant•.'ty Discussed with geolo 'st: - n ) <br /> Type of method ✓�'S <br /> ��` 3 Jtw <br />