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U -ORING WELL. INSTALLATION R POP <br /> �� , &,_2 y CONSTRUCTION <br /> Date: <br /> ToralDepth W7-5 <br /> Premise Address: Screen Len k (from) $7 S CLo) 12-5 <br /> � �'7- S {to)� <br /> Well No.: /JlG(/S Filter Pack (from) <br /> Bentonite {From) !may 5 (to).67- 5 <br /> S <br /> Grout (from) to •-S (to)--� <br /> Insuec.ar: Drilling t*g type CAF 7-5 <br /> Perr:.it No. Z- Auger D.D. 10"1-2, <br /> Complerion- Stove pipe/chrisde box (circle one) <br /> Drilling Company. 9 <br /> // casing <br /> Dr?11er (9� — height <br /> Consultant Q_/(-!� I/d j <br /> r•� `�' <br /> Geologist t3CYr-G�Ct:I�[3 �, SY-3CX <br /> CC WPL ,1CN GOMP:r=�[CN <br /> Ground SLe=* <br /> SPECIAL '?E'4-NUT INFO- <br /> grout <br /> Distance to sewer line d -5 f4- <br /> Domesdc well on site - ( y n <br /> If yes, location and distance - <br /> r � <br /> D <br /> 2106d — m <br /> S ?L NGLiNG Bac on 2' <br /> 72YO pack <br /> Holdiazg Temperature — <br /> Mehod — <br /> Screening Medhod �► <br /> Tracking Sheet - n ) � 1 <br /> SPOILS <br /> Storage �rtethod MA 1-RIALS/DEVELOPI�L?y"I' <br /> Contamination Noted - ( y/ '5a- 4b Q-- <br /> Storage Locadon - Casing type <br /> Blank L ft- Screen [S ft <br /> Slot size • O z- <br /> GROU?-LNG Bags cement <br /> Buckets bentonite <br /> Dept;'h to water Bags sand/gravel <br /> ylix Rados Filter Pack type/size <br /> Installation Method Surge Block: - 0 n ) _ <br /> InsmIl y ins eth Discussed with geologist: - Q�/ nQuan ) <br /> Type of method <br />