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Mc'�-ORING WELL INSTALLATION REPORT <br /> Sr3_ � CONSTRUCTION - I <br /> Date: <br /> Total Depth 35 <br /> Pte:r:ise,Address: Screen Length (from) <br /> - Filter Pack (from) <br /> well No.: r a �' Bentonite (from) 1 Z.5 (to) �/�-- <br /> Grout (from) to <br /> Inspecoor- q �� -S I <br /> IQ Drilling rig type 7 j <br /> 4 / 3 • (� Auger O.D. o� LD. <br /> Permit No. Completion - Stove pipe/chrstie box (circle one) i <br /> i <br /> � Drilling Company'-4 <br /> 3 cas=ng <br /> # Drillers F height <br /> Consultant 6 -'7 <br /> f <br /> y4 1. <br /> F6 <br /> Geologist "` ,�3QVC�RO[!ND _ C�ifil5i�'-30X e J <br /> C.0 WPL-:►;C N COMP:.--i'ICN <br /> Cxamd SUIWS <br /> SpECIAI. PERMT INFO. grout <br /> Distan^ e'ta sewer line d _ /D •S . <br /> Domestic well on site ( y/ n) ;; ` . VZ,5 fL <br /> If yes, location and distance - <br /> 2-1 <br /> _ a <br /> SAMPLING 1 � ' ' &#clan <br /> I-ioiding Temperaturei� .2 <br /> Method <br /> Screening Method — <br /> Tracking Sheet n} 'i, ♦ =71 n, <br /> 6ANIX -5) <br /> SPOILS <br /> Storage Method MA71� LOPMENC <br /> Contamination Noted�G7 n ) <br /> Storage Location Casing type ` <br /> Blank---I< ft- Screen 2 0 ft. <br /> Slot size .O 3 <br /> GROLMNG r± Bags cement <br /> Buckets bentonite / <br /> Depth to water Bags sand/grave! -1 2. <br /> Mix Ratios ►. Filter Pack type/size U' <br /> Installation Method urge B k: - (y/ n) <br /> Quantity Installed l a Discussed th geoIogist: - ( y/ n) <br /> . Type of meth , <br /> �} <br />