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ONITORING WELL INSTALLATION REPO. <br /> �lLrn - � Unn� � Gb� oJt 8Q <br /> Date: 5 a3 - / 2 CONSTRUCTION <br /> Premise Address : $ / r/ re mo j Ski Total Depth A5 <br /> Screen Length (from) (to) -dg�/ Cr ' <br /> Well No. : t/ E - 2 VW ' Z Filter Pack (from) / 'r (to) q'/ <br /> \ . Bentonite (from) 31 <br /> Inspector: _ <br /> d Ar �71 Pti1 Grout (from) � (to) C v <br /> Drilling rig type /' E '7 f <br /> Permit No, Auger O.D. /0 j PL hD. RmL " <br /> Completion - Stove pipe/christie box (cucle one) <br /> Drilling Company: �p�l � WeIf /�bggqn�dartine2� <br /> Driller:014fidy (,FdQ �OJB `P14r TTT casing <br /> height <br /> Consultant !� G <br /> Geologist_ r/ i ✓w 4nye,it — .4C� ' <br /> _ ABOVE-GROUND <br /> OOWLETION CHRISiY <br /> ION <br /> SPECIAL PERMIT INFO. f Gond Surface <br /> Distance to sewer line /V f q grout <br /> Domestic well on site - ( y / n <br /> If yes, location and distance - -I—= h• <br /> s ft. <br /> It. <br /> u <br /> = a <br /> SAMPLING <br /> ebtted � <br /> , r 8 <br /> Holding Temperature 96 Saa p lu uxp fs� 6& 11 i(JG91 � <br /> Method gr'VW Pack <br /> Screening Method_ A/ '{} <br /> Tracking Sheet - ( y / n ) 1\/ _ <br /> /5' ft. ft. <br /> SPOILS "� <br /> Storage Method - //yp /� /U irzJ MATERIALS/DEVELOPMENT <br /> Contamination Noted - ( y / O <br /> Storage Locatioq � Casing type 4q <br /> Blank 5 ft. Screen <br /> GROUTING Slot size n 7 <br /> Bags cement <br /> � qcb R 'BIItkets bentonite 6eteo Oore. U'o /d1 <br /> Depth to water ^� /® ' Bags sand/gravel$ - (Qs„y �go% <br /> Mix RatiosJ 9 � , Filter Pack type/size 3L <br /> Installation Method 99aVr �rr ,,. �� 4e (/ n, �Y �}ar� Surge Block: - ( y / <br /> Quantity Installed .* S �� (� � ,��t Discussed with geologist: - (0 n ) <br /> n Type of method <br /> EH 29 29 •S- <br />