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M( 'ORING WE.L=AUATION REPORT <br /> Date Z - Z'-00 CONSTRU=ON <br /> premise.Addams: L((o0 Total Depa4 7fJ <br /> Screen Length Ctsom) yn (to) S'D <br /> Well No. /nLJ3 Fater Parc CL-om) -70 Cto) YS' <br /> Bentonite CLom) LI K Cto) 'q(--, <br /> Inspedar. C. Grour CEom) Cto) <br /> Drilling ng type 'TAh:nom <br /> Permit No. O/ 9L O L Auger O.D. X LD. <br /> Comoletion- Stove p4me christie box (circle one) <br /> DrMing Company /YJ <br /> 11 ,17 <br /> Duller. �c�� <br /> Consultant A F <br /> B/l GA w t Yirzair 1.^VF��YA////��OCND ' <br /> Ceotogir. ^^ <br /> C,.'M?'_T�N GbiP'SGV <br /> SPEQAL PEP!! T INFO- <br /> 4 <br /> Distance to sewer line �y 'v <br /> Domestic weL or. site - C Y/Q) fav— <br /> if yes,location and distaac_ - it A. <br /> _ o <br /> ila:.Jd — c <br /> SAMPLING <br /> Holding Temperature <br /> Method —_ <br /> Screening Method <br /> TrMaing Sheet <br /> SPOILS <br /> Storage Me:ho rM A fo N MATMIALS/DEMgPMENT <br /> Contamiaadon Noted- CV n) Casing type <br /> Storage LocationBlar_k Screen 7 tt <br /> Slot size 99-7 <br /> GROUTING Bags creme= <br /> Burke batmaire -- <br /> Dench to water r- S Z Bags said/, el — <br /> Mi Racos Flier Pack typdsize a/•a <br /> Insalladon Method 4 r :o .,.2cd 7�� Swage Block - z) <br /> Quantity InsbRed Discussed with geologist <br /> / Type of method rLA�+ <br /> p <br />