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- u A V ONITORiNO WELL INVAUATION RENO <br /> CONSTRUCTION <br /> Premise Address: 2 La-�� ZI tp a Total Depth <br /> Screen Length (from) (ro) <br /> Well No.: �� Filter Pack (from) (to.) <br /> (from) (to) <br /> Inspector. K Q' S Grout ME) {to) <br /> Drilling ng type <br /> Permit No. 5 Auger O.D. I.D. <br /> Completion-Stove pipe/christie box (circle one) <br /> Drilling Company: Z. <br /> Drdler: cas Lnq <br /> T heLght <br /> consultant �� �. <br /> Geologist ABOV154RCUND <br /> COi1Rrll:T10N <br /> CrVU5�racCOMPLETION <br /> Ld <br /> Distance to sewer linegout <br /> Domestic well on site- (y <br /> if yes,location and distance - R <br /> aac'1cn <br /> Holding Tem lure Ct " ' pay.l pads <br /> Meth <br /> ScreenW9 Method 1 _ <br /> Tracking Sheet - {y/n) <br /> R. n <br /> ZL <br /> i <br /> SPOILS <br /> Storage Method_ 0, WTERIALS/DEnLOPMENT <br /> Contamination Noted-{y/n} W F�C <br /> Storage Location ming e <br /> Blank ft. Screen ft. <br /> slot size <br /> GRE Bags cement <br /> Buckets bentonite <br /> Depth to water l. Bags sand/gravel <br /> Mix Ratios Filter Pack type/ Me <br /> Installation Method 6111 p' Surge Block: - / n) <br /> Quantity Installed Discussed with geologist: - n) <br /> Type of method <br /> EH 29 29 <br /> 45' <br />