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MONITORING WELL INSTALLATION RW--T <br /> Date: he,✓ CONSTRUCTION <br /> Premise Address: 32 3O P S+ L.Q e, Total Depth gq <br /> Screen Length (from) :7ff`49.� <br /> Well No.: &W -4 Filter Pack (from) "72` (to) 6-9 ` ht <br /> Bentonite (from) 5-9 , (to) 5 <br /> Inspector: - Vink; fV( cd r+n e"a Grout (from)_ 5--l ' (to)_ S vY-jca r � <br /> O© Q Drilling rig type 5- <br /> Permit No. Auger O.D. �T D. 2� in ,� <br /> Drilling Company:_ Completion - Stove pipe/ stie o (circle one) <br /> �,$�e=��"` � ` <br /> Driller: :f 4l Ld S Lld q D vs- casing <br /> �ss,`J+a,�4ss Mar-t`o tBrnvs ano( (fArlosFeas height <br /> Consultant A 6-E <br /> GeologistTi M 6fe!lar ._ a AE;0V -GROUND <br /> GONFLETCN <br /> SPECIAL PERMIT INFO. f, Grnu�d St�acv <br /> Distance to sewer line f)✓1 k'n fl � gram <br /> Domestic well on site - (y/(ED <br /> If yes, location and distance - ft. <br /> tt. <br /> m <br /> c <br /> SAMPLING — <br /> slottad _ E <br /> -aacdon- — <br /> Holding Temperature -'v 4 se <br /> _ . <br /> >HveI <br /> Method r`61 e- V& packScreening Method N 67 ' <br /> - <br /> Tracking Sheet n <br /> w z- ft. <br /> SPOILS -rd f� -US--4 7-Sb ,bvck6 <br /> CcC-- �-�yy��� <br /> Storage Method / r msQl2 c,t� MATERI�ALS/DEVEI;OP�MENT��� <br /> Contamination Noted - ( y `� /ifs. <br /> Storage Location QCasing type Se e_d le_ 4O V . <br /> Blank 66 ft. Screen_ /d ft. <br /> �/ Slot size X20 irZcl. <br /> GROUTING 7 b ��-� �� � Bags cement ( 4 P j <br /> Buckets bentonite /z <br /> Depth to waterA15D Bags sand/gravel <br /> Mix Ratios +o -/& ti 35;qa116,,,qz) Filter Pack type/size <br /> Installation Method rov f ro v 1 - {'$ /aS Surge Block: -�V n ) <br /> Quantity Installed -o v 3) Discussed with geologist: - n ) <br /> r •/ Type of method <br /> EH 29 29 TGu_ boY, t�,)4-f G�n i 11 4V 6j_1 hi <br /> to(ij L'-O�f /Zd��-� ✓7/G��1.LN� �iY Cf 1- 7U��'5�� i 9�U L��liC/.�/�fj7F� 1�J2.J <br />