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MONITORING WELL INSTALLATION REPORT <br /> Date: <br /> Oc <br /> Premise Address: 6 ( y l CONCON—CUON <br /> well No.: Total Depth 450 <br /> - Screen Length (from)_ - <br /> Inspector. Nati Piller Pack (from) -- -r--(to) <br /> Bentonite (from)---�(to) sb r <br /> Permit No. Grout (from) — 1— (to)� <br /> Drilling rig type -- �(to) � <br /> Drilling Company: C Ager O.D. <br /> Com letion - I.D. <br /> DrillerP. Stove pipe/duictlpe box (c�) <br /> Consultant <br /> casing <br /> 4�Geologist height <br /> &L, G2 —WT <br /> SABOVE-GACUND <br /> PECIAL PER? INFO. 00kPLETION <br /> C7•W7Sty30X ' <br /> Distance to server line —'�'-�Gnx:nd SL fyc t comptznCN <br /> Domestic well on site <br /> "Yes, location and disce ) grout <br /> - <br /> sR - 7-3 eft. <br /> ft. <br /> S -a <br /> Holding Temperatureslocni <br /> Method sodon <br /> Greening Method <br /> Tracking Shcet - n ) '= = 9•avotyk�k <br /> SPOILS <br /> Storage Method ft' <br /> Contamination Noted - <br /> Storage Location n) MATERIALS EVELOPMENT <br /> Casing type . <br /> GR�U-nNG Blank , - <br /> fL <br /> Slot stze~ Screen <br /> Depth to water. 36 Bags cement 2.y^ <br /> Mix Ratios Buckets bentonite <br /> Installation Meth d Bags sand/gravel <br /> Quantity Installed Filter Pack type/size -2. <br /> - dya (�ati� Surge Block: • (y/ <br /> " <br /> EH 29 29 - Discussed with N <br /> Type of mcthodgcol g r. - (Y n <br /> j <br />