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`40NiTORING WELL INSTALLATION REPO'-'' <br /> Date: i l , 1 1 gONSTRUCt'ICEN <br /> Pie miseAttdresst�lIG stn ,; mak' p <br /> _ Tota2 De c' <br /> Screen Length (from) c <br /> well No.. nl►tn� "2:� Filter Paclt (from) A <br /> Bentonite: (from) a `t�,z 60 <br /> Inspector.. reik s, Grout (from) 1 (to) - t <br /> Drilling rig type <br /> Permit No `-�Z� Auger O.D. I.D: <br /> Completion Stove pipelchristie 14 (vci{ le ane) <br /> DrillingCorn. an <br /> Driller. �-�- <br /> : �� Casing <br /> heights <br /> Consultant <br /> %7. <br /> Gealogxsr i tit I xA .�_�,na��.- <br /> ABOVE-GAOUND GW tSIY-BC)X <br /> CC9 1C'iN COMPLETION <br /> TION <br /> SPECIAL PERMIT INFO, Gond*v`txfati �..�. <br /> Distance to sewer lire g`°` <br /> Domestic well on site - (y/n) <br /> If yes,location and distance - <br /> �v <br /> t <br /> SAMPLING std v <br /> Holding Temperature as r . 9MVW <br /> Method ��4f/ jua—T,ri t'�p./ Q !�^ <br /> Screening Method P%n : <br /> Tracking Sheet . ( n <br /> WIN <br /> SPQU <br /> Storage Methods r ;i�.. MATERiALS/DEVELAPMENT <br /> . ( /m) <br /> Contamunanon Noted - Y <br /> Storage Location m.. �; , fi ti� .. �ti � � Casing type 2_ r(sh C t j d <br /> Blank5`- ft. Screen <br /> Slot size * 0 2-0 <br /> GR4Bags cement <br /> Buckets beentorttt+e -,- <br /> Depth to water. 35Bags sand/gravel=t Ya f roc C(- <br /> 1 <br /> Mix Rarios �4'4 J L - ..7 t� , Filter Pack typesize <br /> Installation Method '' Surge Block. /n <br /> QuantityInstalled T—` r. ,�:�. > Discussed wrath:i <br /> n..). <br /> Type of method <br /> EH 29 29 <br />